US hospital preparedness for obstetrics patients with possible Ebola.

ince early March 2014, >20,000 probable and suspect addresses considerations for pregnant women with epidemiS cases of Ebola virus disease (EVD) have been reported in Guinea, Sierra Leone, and Liberia, with more than 8000 deaths reported as of Jan. 4, 2015. Although pregnancy data are limited, reports of pregnant women with EVD in this and previous outbreaks describe very high maternal, fetal, and neonatal death rates. The diagnosis of EVD remains rare in the United States with only 4 confirmed cases and none among pregnant women. Because the greatest risks for exposure to Ebola virus remain residence in or travel to countries with wide-spread Ebola virus transmission, pregnant women should continue to be screened regarding recent international travel and potential exposure to Ebola virus. Health care providers who care for pregnant women should identify those women who are at risk for EVD and, as described by Minkoff and Ecker, have an obligation to ensure safe, prompt, and appropriate care. Pregnant women who have traveled recently from a country with wide-spread Ebola virus transmission (http://www.cdc.gov/vhf/ebola/outbreaks/ 2014-west-africa/case-counts.html) or have had exposure to a person with EVD within the past 21 days and who are exhibiting EVD-compatible signs or symptoms (fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, or unexplained hemorrhage) require isolation, triage, and appropriate evaluation. While being evaluated, pregnant women require continuous access to care. The vast majority of pregnant women (even those with recent travel to countries with wide-spread Ebola virus transmission) do not have EVD; therefore, it is critical that there be no delay or interruption in care, and it is equally important that other diagnoses are considered while an evaluation for possible EVD is being conducted. This editorial