Will scrub typhus force an early delivery in pregnancy?

Question

Hello doctor,

My cousin, 26 years old, is 8 months pregnant and got scrub typhus. The doctors changed her antibiotics three times but her fever is not improving. She has been having severe back pain and reduced fetal movement since yesterday. Her platelets were dropping and they found protein in her urine. Will this force an early delivery? What is the risk to the baby? She has already had two miscarriages before.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I am sorry to hear about your cousin's difficult situation. Scrub typhus during pregnancy can be serious, especially if it is not responding to antibiotics, and the symptoms you are describing (fever, severe back pain, reduced fetal movement, platelet drop, and protein in urine) could indicate a potentially serious complication, such as preeclampsia (pregnancy complication characterized by high blood pressure and signs of organ dysfunction) or an infection-related complication.

If scrub typhus is not adequately controlled, it can affect both the mother and baby. The infection itself could lead to fetal distress, intrauterine growth restriction (IUGR), or even fetal death in severe cases.

The presence of protein in the urine and dropping platelets might suggest preeclampsia or HELLP syndrome (a severe form of preeclampsia). These conditions can cause high blood pressure and can be life-threatening to both mother and baby if not managed carefully. Preeclampsia can result in premature birth if the condition becomes severe or life-threatening.

This is concerning because it can be a sign that the baby is under stress. Reduced movement can be linked to problems such as intrauterine infection, hypoxia (lack of oxygen), or other complications.

If the mother's condition worsens or the baby shows signs of distress (like reduced movement or abnormal heart rate), doctors may recommend early delivery to protect both mother and baby. This might happen sooner if preeclampsia or another complication develops. Monitoring and next steps:

Your cousin must be closely monitored by her healthcare team. They may do additional tests like fetal heart monitoring, blood tests, and ultrasounds to evaluate the health of both mother and baby.
The doctors will make decisions based on the severity of her symptoms and the baby’s well-being.
Given her history of previous miscarriages, the medical team will be taking every precaution to manage the situation as carefully as possible.
Encourage your cousin to stay in close contact with her healthcare providers, and if there are any changes in her symptoms, like a sudden drop in fetal movement, more intense back pain, or worsening fever, she should get immediate medical attention.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.