title: Ebola Virus Disease in Pregnancy: Clinical, Histopathologic, and Immunohistochemical Findings.
abstract: Here we describe clinicopathologic features of Ebola virus disease in pregnancy. One woman infected with Sudan virus in Gulu, Uganda, in 2000 had a stillbirth and survived, and another woman infected with Bundibugyo virus had a live birth with maternal and infant death in Isiro, the Democratic Republic of the Congo in 2012. Ebolavirus antigen was seen in the syncytiotrophoblast and placental maternal mononuclear cells by immunohistochemical analysis, and no antigen was seen in fetal placental stromal cells or fetal organs. In the Gulu case, ebolavirus antigen localized to malarial parasite pigment-laden macrophages. These data suggest that trophoblast infection may be a mechanism of transplacental ebolavirus transmission.
authors.affiliation: Infectious Diseases Pathology Branch.
authors.forename: Atis
authors.initials: A
authors.lastname: Muehlenbachs
authors.affiliation: Médecins Sans Frontières, Barcelona, Spain.
authors.forename: Olimpia
authors.initials: O
authors.lastname: de la Rosa Vázquez
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Bausch
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Ilana J
authors.initials: IJ
authors.lastname: Schafer
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Paddock
authors.affiliation: Médecins Sans Frontières.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Nyakio
authors.affiliation: Médecins Sans Frontières.
authors.forename: Papys
authors.initials: P
authors.lastname: Lame
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Eric
authors.initials: E
authors.lastname: Bergeron
authors.affiliation: Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: McCollum
authors.affiliation: Infectious Diseases Pathology Branch.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Goldsmith
authors.affiliation: Infectious Diseases Pathology Branch.
authors.forename: Brigid C
authors.initials: BC
authors.lastname: Bollweg
authors.affiliation: Médecins Sans Frontières, Barcelona, Spain.
authors.forename: Miriam Alía
authors.initials: MA
authors.lastname: Prieto
authors.affiliation: Ministry of Health, Kinshasa, Democratic Republic of the Congo.
authors.forename: Robert Shongo
authors.initials: RS
authors.lastname: Lushima
authors.affiliation: Ministry of Health, Kinshasa, Democratic Republic of the Congo.
authors.forename: Benoit Kebela
authors.initials: BK
authors.lastname: Ilunga
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Nichol
authors.affiliation: Infectious Diseases Pathology Branch.
authors.forename: Wun-Ju
authors.initials: WJ
authors.lastname: Shieh
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Ute
authors.initials: U
authors.lastname: Ströher
authors.affiliation: Viral Special Pathogens Branch.
authors.forename: Pierre E
authors.initials: PE
authors.lastname: Rollin
authors.affiliation: Infectious Diseases Pathology Branch.
authors.forename: Sherif R
authors.initials: SR
authors.lastname: Zaki
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology / Q000302:isolation & purification; D015023:Democratic Republic of the Congo; D029043:Ebolavirus / Q000737:chemistry / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D019142:Hemorrhagic Fever, Ebola / Q000276:immunology / Q000473:pathology* / Q000635:transmission / Q000821:virology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007150:Immunohistochemistry; D008264:Macrophages / Q000469:parasitology / Q000648:ultrastructure / Q000821:virology; D008288:Malaria / Q000150:complications / Q000276:immunology / Q000821:virology; D046529:Microscopy, Electron, Transmission; D010920:Placenta / Q000648:ultrastructure / Q000821:virology; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000469:parasitology / Q000473:pathology* / Q000821:virology*; D050497:Stillbirth; D017154:Stromal Cells / Q000648:ultrastructure / Q000821:virology; D014327:Trophoblasts / Q000469:parasitology / Q000648:ultrastructure / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Bundibugyo virus; Ebola virus disease; Sudan virus; malaria; pathology; placenta; pregnancy