The impact of scrub typhus in pregnancy is less
explored. In a case series of eight patients treated for
acute scrub typhus during pregnancy (confirmed by
indirect immunofluorescence assay), Kim et al[50]describe
a healthy outcome for both mothers and babies (without
any congenital infections or malformations). All patients
had an uncomplicated illness and gestational age at
presentation varied between 10-29weeks. However poor
foetal outcome has been reported; Mathai et al[51]report
of four women with scrub typhus in the second trimester,
treated with ciprofloxacin, who all had miscarriages or
still births. In another case report, an infected woman was
treated with chloramphenicol successfully at 29weeks of
gestation. However the baby was born prematurely and
died subsequently (no vertical transmission demonstrated)
[52]. Neonatal scrub typhus has been reported in two
instances with cord blood being positive for IgM[53,54]. Acute
scrub typhus can be transmitted vertically but congenital
malformation due to infection per se, has not been
demonstrated