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
In the context of rigorous research or in accordance with the MEURI protocol, the use of the investigational therapies REGN-EB3 or mAb114 may be offered to pregnant women with Ebola virus disease
Notes and Remarks
- 1.Optimized supportive care includes systematic assessment and re-assessment of patients with EVD, fluid resuscitation, electrolyte monitoring and correction, glucose monitoring and management, treatment of potential co-infections, and nutritional support. Symptomatic care, as well as prevention and management of complications, should always be provided
- 2.Based on evidence from general adult populations, applying the principles of optimized supportive care to pregnant populations with EVD will likely decrease mortality and confer a beneficial impact on disease outcomes
- 3.The use of fluid resuscitation in pregnant women with EVD, such as oral rehydration and parenteral administration of clinically appropriate fluids, has not been specifically evaluated. However, among adults with EVD, correction of intravascular depletion through adequate fluid resuscitation likely improves survival
- 4.Where available, intensive critical care such as non-invasive ventilation, intubation with mechanical ventilation, central venous line insertion with vasopressor support, or renal replacement therapy will likely benefit pregnant women with EVD similar to that observed in adults with EVD.
- 5.The Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) expert panel recommends that “access to and use of investigational therapeutics under MEURI be carefully considered for each individual patient, including for vulnerable populations such as pregnant women and paediatric patients, as appropriate given the available data.” In general, the expert panel recommends consideration of factors such as disease severity and risks/benefits of investigational therapy (including adverse effects in pregnant or paediatric populations)
- 6.Pregnant women with acute EVD who are not treated with investigational or compassionate use agents experience very high (>95%) rates of spontaneous abortion, foetal or neonatal death.
- 7.Further information regarding this recommendation can be found in the WHO publications: “Optimized Supportive Care for Ebola virus disease: Clinical management standard operating procedures” ; “Notes for the record: Consultation on Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) for Ebola virus disease” and “Guidance for managing ethical issues in infectious disease outbreaks”
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