What is the treatment for mumps in pregnancy?

Treatment of Mumps in Pregnancy

Mumps in pregnancy is managed with supportive care only—there is no specific antiviral treatment, and the mumps vaccine is contraindicated during pregnancy. 1

Primary Symptomatic Management

The cornerstone of treatment is symptom relief:

• Provide acetaminophen or NSAIDs for pain and fever control to manage fever, headache, and parotid gland pain. 1
• Ensure adequate hydration and fluid intake, as parotitis makes swallowing uncomfortable and painful. 1
• Recommend soft foods and avoidance of acidic foods that may stimulate salivary flow and worsen parotid pain. 1

Strict Isolation Requirements

Pregnant women with mumps require immediate isolation to prevent transmission:

• Implement droplet precautions immediately, as patients are contagious from 7 days before through 8 days after parotitis onset. 1
• Isolate for 5 days after onset of parotitis to limit spread to susceptible contacts. 1
• Educate family members about transmission through respiratory droplets and direct contact with saliva. 1

Monitoring for Complications

Pregnant women require vigilant monitoring, as complications can be more severe in adults:

Neurological Complications

• Monitor for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status. 1
• Watch for signs of encephalitis, including seizures, paralysis, or cranial nerve palsies, which can cause permanent sequelae. 1
• Assess for hearing loss, including sudden sensorineural deafness. 1

Reproductive and Systemic Complications

• Monitor for oophoritis (ovarian inflammation) in pregnant women, which can present with pelvic pain. 1
• Watch for pancreatitis, characterized by severe abdominal pain, nausea, and vomiting. 1

Pregnancy-Specific Considerations

• Mumps in pregnancy may increase the risk of premature birth, though severe fetal complications are rare. 2
• There is no evidence that mumps causes congenital malformations, unlike rubella. 3, 2
• A 1966 study suggested increased abortion risk with first-trimester mumps, but subsequent studies have not consistently confirmed this association. 2

Special Management: Facial Nerve Involvement

If facial nerve inflammation occurs:

• Initiate corticosteroid therapy promptly with prednisone 1-2 mg/kg/day for 5-7 days followed by a taper over 5-7 days to reduce inflammation and improve nerve function. 1
• Provide eye protection to prevent corneal damage in patients with facial weakness. 1
• Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months. 1

Critical Clinical Caveats

• Mumps disease is generally self-limiting, with most patients recovering without intervention beyond supportive care. 1
• Parotitis is not present in all cases—only 30-40% of mumps infections produce typical acute parotitis, while 15-20% are asymptomatic and up to 50% present with nonspecific or respiratory symptoms. 1, 4
• Complications are more common and severe in adults than children, making age an important consideration in monitoring intensity. 1
• The mumps vaccine is contraindicated during pregnancy due to theoretical risk of fetal harm from live-virus vaccine, though accidental vaccination has not been shown to cause maternal/fetal complications. 3, 5
• MMR immunization should be administered to nonimmune obstetric patients upon completion or termination of pregnancy to prevent future infections. 5