Bibliographic Info
GuidelineWHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year of Publication2023
Issuing InstitutionWorld Health Organization
Recommendation
Status
Maintained
Recommended in favor
Strong
Certainty of evidence
Very low
All pregnant women with acute Ebola virus disease should be managed using both standard precautions and Ebola-specific Infection Prevention and Control (IPC) measures
Notes and Remarks
- 1.Although the actual risk of EVD transmission from pregnant women following recovery is unclear, there is evidence that Ebola RNA can remain detectable in amniotic fluid, placental tissue, foetal tissue, and vaginal secretions. This evidence enables WHO to make strong recommendations regarding the necessity of Ebola-specific IPC measures for pregnant women who have recovered from EVD (with conception prior to EVD) in situations with potential for pregnancy-related fluid or tissue exposure. However, if the pregnancy was conceived after EVD, there is no known risk of EVD transmission with exposure to pregnancy-related fluids and tissues, and therefore only standard precautions are necessary.
- 2.Effective IPC measures require a hierarchy of engineering, environmental and administrative controls in order to block viral spread in healthcare facilitates. In addition to PPE, IPC includes, but is not limited to, barrier nursing, hand hygiene, and waste management (56).
- 3.EVD transmission has been linked to traditional funeral ceremonies. Similarly, there is likely a high risk of transmission from post-mortem caesareans for pregnant women who have died from EVD. Guidelines on how to conduct safe and dignified burials for patients with suspected or confirmed EVD should be followed in the event of a maternal death from EVD, including the recommendation that only trained personnel should handle human remains, handling should be minimal, and cultural and religious considerations should be taken into account (46)
- 4.Actions (such as an invasive procedure) should not be taken in the event of foetal distress in pregnant women with acute EVD. As such, foetal monitoring during labour is not necessary. * Further information regarding this recommendation can be found in the WHO publications: “Interim guidance: Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in healthcare settings, with focus on Ebola” (53), “Interim guidance: Clinical care for survivors of Ebola virus disease” (54), and “Standard precautions in health care. Aide-memoir” (52). Further information regarding recommendation 8 can be found in the WHO publication “Interim guidance: How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola or Marburg virus disease” (46).
Also Featured In
This recommendation also appears in the following guidelines:
Originally Developed
Guideline
Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease
Year2020
InstitutionWHO