title: Anticipated and unanticipated complications of severe dengue in a primigravida.
abstract: As the incidence of dengue is rising among adults more cases of dengue fever are being reported during pregnancy. Physiological changes of pregnancy mask the pathognomonic features of severe dengue such as increased hematocrit, thrombocytopenia, and leukopenia and a high index of suspicion are required in endemic areas. Massive hemorrhage may complicate operative deliveries in unsuspected patients. World Health Organization recommends that all patients with severe dengue should be admitted to a hospital with access to intensive care facilities and blood transfusion. We present the successful management of hemorrhage and unanticipated complications of severe dengue in a young primigravida admitted to the Intensive Care Unit after an emergency cesarean section.
authors.affiliation: Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Madiha
authors.initials: M
authors.lastname: Hashmi
authors.affiliation: Department of Gynaecology and Obstetrics, Aga Khan University, Karachi, Pakistan.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Zainab
authors.affiliation: Department of Gynaecology and Obstetrics, Aga Khan University, Karachi, Pakistan.
authors.forename: Farah
authors.initials: F
authors.lastname: Khan
keywords: Severe dengue; blood transfusion; intensive care units; pregnancy; thrombocytopenia