<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-3349</journal-id>
<journal-title><![CDATA[Revista de salud publica del Paraguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. salud publica Parag.]]></abbrev-journal-title>
<issn>2307-3349</issn>
<publisher>
<publisher-name><![CDATA[INSTITUTO NACIONAL DE SALUD - MSP Y BS]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-33492025000200004</article-id>
<article-id pub-id-type="doi">10.18004/rspp.2025.ago.02</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Dengue en embarazadas en Paraguay: predominio del tercer trimestre y baja mortalidad materna en contexto altamente endémico]]></article-title>
<article-title xml:lang="en"><![CDATA[Dengue in pregnant women in Paraguay: third-trimester predominance and low maternal mortality in a highly endemic setting]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilera López]]></surname>
<given-names><![CDATA[Enrique Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brizuela Quiñónez]]></surname>
<given-names><![CDATA[Jorge Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barboza Molinas]]></surname>
<given-names><![CDATA[Erwin José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad del Pacífico Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<volume>15</volume>
<numero>2</numero>
<fpage>4</fpage>
<lpage>9</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-33492025000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-33492025000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-33492025000200004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Paraguay es el segundo país con mayor incidencia de dengue en América Latina según la Organización Panamericana de la Salud. Durante el embarazo, esta enfermedad endémica puede presentar complicaciones graves materno-fetales, sin embargo, existe limitada evidencia sobre sus características clínicas en el contexto paraguayo.  Objetivo:  Caracterizar las manifestaciones clínicas y complicaciones del dengue durante el embarazo en pacientes atendidas en el Hospital Nacional de Itauguá, Paraguay.  Materiales y métodos:  Estudio observacional descriptivo retrospectivo de 112 embarazadas con dengue confirmado por criterios clínicos y laboratoriales (antígeno NS1, IgM/IgG-ELISA, PCR) durante el período junio 2023-junio 2024. Se analizaron características sociodemográficas, manifestaciones clínicas según trimestre gestacional, comorbilidades y complicaciones materno-fetales mediante estadística descriptiva.  Resultados:  La edad predominante fue 26-33 años (42,9%), con 70,5% de residencia urbana. El 52,7% de los casos ocurrieron en tercer trimestre, contrastando con estudios previos que reportan predominio en primer y segundo trimestre. Las manifestaciones principales fueron fiebre (90,2%), cefalea (66,1%) y mialgias (49,1%). Los vómitos predominaron en primer trimestre (47,6%), mientras que las mialgias y dolor abdominal aumentaron hacia el tercer trimestre. Se registraron abortos espontáneos en 2,7% de los casos (exclusivamente primer trimestre) y mortalidad materna en 1,8% (únicamente tercer trimestre). Las comorbilidades prevalentes fueron hipertensión arterial (16,1%) y diabetes mellitus (8,0%).  Conclusión:  Este estudio documenta mayor frecuencia de dengue gestacional en tercer trimestre, contrastando con la literatura previa. La mortalidad materna (1,8%) fue menor que los reportes internacionales (5,8-13,6%). La variación sintomática según trimestre gestacional evidencia la necesidad de desarrollar protocolos específicos para dengue gestacional en Paraguay, proporcionando evidencia nacional para el desarrollo de guías clínicas adaptadas al contexto endémico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Paraguay is the second country with the highest incidence of dengue in Latin America according to the Pan American Health Organization. During pregnancy, this endemic disease can present serious maternal-fetal complications; however, there is limited evidence regarding its clinical characteristics in the Paraguayan context.  Objective:  To characterize the clinical manifestations and complications of dengue during pregnancy in patients treated at the National Hospital of Itauguá, Paraguay.  Materials and methods:  A retrospective, descriptive, observational study of 112 pregnant women with dengue confirmed by clinical and laboratory criteria (NS1 antigen, IgM/IgG-ELISA, PCR) during the period from June 2023 to June 2024. Sociodemographic characteristics, clinical manifestations by gestational trimester, comorbidities, and maternal-fetal complications were analyzed using descriptive statistics.  Results:  The predominant age group was 26-33 years (42.9%), with 70.5% of urban residence. Most cases occurred in the third trimester (52.7%), contrasting with previous studies that report predominance in the first and second trimesters. The main manifestations were fever (90.2%), headache (66.1%), and myalgia (49.1%). Vomiting predominated in the first trimester (47.6%), while myalgia and abdominal pain increased toward the third trimester. Spontaneous abortions were recorded in 2.7% of cases (exclusively first trimester) and maternal mortality in 1.8% (only third trimester). The prevalent comorbidities were arterial hypertension (16.1%) and diabetes mellitus (8.0%).  Conclusion:  This study documents a higher frequency of gestational dengue in the third trimester, contrasting with previous literature. Maternal mortality (1.8%) was lower than international reports (5.8-13.6%). The symptomatic variation according to gestational trimester demonstrates the need to develop specific protocols for gestational dengue in Paraguay, providing national evidence for the development of clinical guidelines adapted to the endemic context.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[dengue]]></kwd>
<kwd lng="es"><![CDATA[embarazo]]></kwd>
<kwd lng="es"><![CDATA[complicaciones obstétricas]]></kwd>
<kwd lng="es"><![CDATA[salud materno-fetal]]></kwd>
<kwd lng="en"><![CDATA[dengue]]></kwd>
<kwd lng="en"><![CDATA[pregnancy]]></kwd>
<kwd lng="en"><![CDATA[obstetric complications]]></kwd>
<kwd lng="en"><![CDATA[maternal-fetal health]]></kwd>
</kwd-group>
</article-meta>
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