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Obstetric outcomes in pregnant women with subacute sclerosing panencephalitis (SSPE): a systematic review of case reports and case series

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Abstract

Background

Subacute sclerosing panencephalitis (SSPE) is a devastating brain disease caused by persistent infection by the measles virus. Several cases of SSPE in pregnant ladies have been described. This systematic review is focused on maternal and foetal outcomes among pregnant women with SSPE.

Methods

We searched four databases (PubMed, Embase, Scopus, and Google Scholar). We reviewed all relevant cases, published until 14 August 2022. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was registered with PROSPERO (CRD42022348630). The search items that we used were “((Pregnancy) OR (delivery)) AND (Subacute sclerosing panencephalitis (SSPE))”. Dyken’s criteria were used for the diagnosis of SSPE in pregnant women. The extracted data was recorded in an Excel sheet. The Joanna Briggs Institute Critical Appraisal tool for case reports was used to assess the quality of published cases.

Results

We came across 19 reports describing details of 21 cases. The age of SSPE-affected women varied from 14 to 34 years (mean 23 years). In the majority (n=14), clinical manifestations were started in the antepartum period. Nine pregnant SSPE women presented with vision loss. After delivery, 13 SSPE-affected women died. On the contrary, 15 foetuses, though the majority were preterm, were alive. Five foetuses either died soon after birth or were still-born.

Conclusion

In conclusion, SSPE in pregnancy is often missed, as it mimics eclampsia. SSPE in pregnancy usually has a devastating course. Universal early childhood measles vaccination is the only way to fight this menace.

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Authors and Affiliations

  1. Department of Neurology, King George’s Medical University, Lucknow, 226003, India

    Ravindra Kumar Garg, Imran Rizvi, Shweta Pandey & Ravi Uniyal

  2. Department of Neurology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, 226001, India

    Vimal Paliwal

  3. Department of Obstetrics and Gynaecology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226001, India

    Smriti Agrawal

  4. Department of Pedodontics, King George’s Medical University, Lucknow, 226003, India

    Richa Khanna

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  1. Ravindra Kumar Garg
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Correspondence to Ravindra Kumar Garg.

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Supplementary information

Supplementary file 1

Supplementary item-1: Search strategy, Supplementary item-2: Diagnostic criteria of SSPE, Supplementary item-3: PRISMA checklist, Supplementary item-4: The Joanna Briggs Institute Critical Appraisal tool for case reports.

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Garg, R.K., Paliwal, V., Rizvi, I. et al. Obstetric outcomes in pregnant women with subacute sclerosing panencephalitis (SSPE): a systematic review of case reports and case series. Neurol Sci 44, 1959–1968 (2023). https://doi.org/10.1007/s10072-023-06650-x

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