Overview

A paucity of scientific evidence exists on how to best treat pregnant or breastfeeding women with suspected or confirmed Ebola virus disease (EVD). Historical reports suggest that, among women who acquire EVD during pregnancy, there is increased mortality and morbidity, and a near 100% rate of adverse pregnancy outcomes

To save the lives of mothers and their babies, mitigate complications, and limit the spread of disease, it is critical that recommendations are made on the prevention, treatment, and surveillance of women who are exposed to EVD, acquire EVD during pregnancy or breastfeeding, or survive EVD with ongoing pregnancies. These guidelines are the first to provide such recommendations.

Contents

• Acknowledgements
• Acronyms and abbreviations
• Executive summary
  • Recommendation categories
• Producing the guidelines
  • Gathering the evidence
  • Plans for updating
• Dissemination, adaptation, implementation and evaluation
  • Recommendation categories
• Recommendations
  • Guiding principles
  • 1. Treatment of pregnant women with acute Ebola virus disease
  • 2. Induced abortion and induction of labour in women with acute EVD
  • 3. Infection prevention and control measures for pregnant women with EVD
  • 4. Infection prevention and control for breastfeeding women in the context of EVD
  • 5. Use of rVSV-ZEBOV-GP Ebola vaccine in pregnant women
• Considerations for implementation
• Research priorities
• Funding
• References
• Annexes
  • Annex 1. Additional considerations for implementation: Management of breastfeeding and pregnant women with acute or recovered EVD (with conception prior to EVD)
  • Annex 2. Evidence-to-decision tables
  • Annex 3. Contributors

Suggested citation:

Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.

General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.

Families and communities across several countries have endured Ebola virus disease in recent years.

The image on the front cover of these guidelines is based on a picture from the Democratic Republic of the Congo.