Vertical Transmission of Chikungunya Manifesting as Foetal Pericardial Effusion

Chikungunya fever is believed to be a self-limiting illness, which can result in significant disability, but with a very low mortality. Chikungunya is uncommonly believed to be associated with serious manifestations. The present case is of a pregnant lady who had transient fever for two days in the third trimester, following which she developed foetal pericardial effusion and intrauterine growth restriction. After two weeks of the fever, in view of non-reactive non-stress test, breech and foetal pericardial effusion, patient was taken up for caesarean section. The neonate was positive for Chikungunya, detected by RT-PCR, while the mother tested positive for Chikungunya IgM antibodies. A diagnosis of Chikungunya pericardial effusion was made in the neonate, presumably acquired vertically secondary to the maternal Chikungunya infection occurring in the third trimester, which was also contributory to intrauterine growth restriction. No case of vertical transmission of Chikungunya has been reported in India, and foetal pericardial effusion has not been reported in world literature.