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*The name of the specific orthopoxvirus of concern, "monkeypox virus," is used in this resource to be congruent with existing nomenclature, available recommendations, and literature on the topic. ACOG recognizes and acknowledges the stigma associated with the name and is closely following developments related to the potential renaming of the virus.

Background

Since early May 2022, cases of monkeypox have been reported in nonendemic parts of the world and the Centers for Disease Control and Prevention (CDC) and its local health partners are tracking thousands of cases of monkeypox in the United States. On July 30, 2022, the CDC released a Health Alert Network Health Update summarizing the available recommendations and resources for certain populations, including pregnant and breastfeeding individuals.

Monkeypox is caused by infection with the Monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. It is not related to the virus that causes chickenpox, varicella-zoster virus. Monkeypox symptoms are similar to smallpox symptoms and usually include fever, headache, muscle aches, swollen lymph nodes, respiratory symptoms, and a rash that can look like pimples or blisters or vesicles that can appear on the face, hands, feet, chest, genitals, or anus, or inside the mouth (CDC Clinical Recognition). The rash can be painful. The mortality rate of the currently circulating monkeypox virus clade is low with prompt supportive care. To date, there have been very few deaths worldwide.

Monkeypox spreads from person to person through direct contact with the infectious rash, scabs, or body fluids; respiratory secretions during prolonged face-to-face contact, or during intimate physical contact (such as kissing, cuddling, or sex); and touching items (such as clothing or linens) that previously touched the infectious rash or body fluids. It is also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal (CDC Transmission).

Pregnant people can spread the virus to their fetus through the placenta and through close contact with the newborn (CDC Transmission).

Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2–4 weeks. Spread of monkeypox from people without symptoms has not been observed. At this time, it is not known whether monkeypox can spread through semen, vaginal fluids, or breast milk (CDC Transmission).

For more details on monkeypox diagnosis, management, treatment, and prevention during pregnancy, see ACOG's Frequently Asked Questions below.

Frequently Asked Questions

General Considerations

Staffing, Personnel, and Hospital Resources

Vaccination

Treatment

Prenatal Care

Intrapartum Care

Postpartum Care

Please contact [email protected] with any questions.

Additional Resources


This document has been developed to respond to some of the questions facing clinicians providing care during the rapidly evolving monkeypox virus outbreak situation. As the situation evolves, this document may be updated or supplemented to incorporate new data and relevant information. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center.

While ACOG makes every effort to present accurate and reliable information, this publication is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.

All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on acog.org. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product.