Table 3.

Management of the neonate

General management	• Neonatology team should be informed of all cases
Management of neonates delivered by cesarean delivery	• Low risk of vertically transmitted monkeypox infection
	• No active treatment required
	• Monitor for skin, eye, and mucous membrane lesions, irritability, and poor feeding
	• Delay breastfeeding and skin-to-skin until the mother is deisolated
Management of neonates delivered vaginally (eg, birth before arrival or precipitate labor in mothers with active or suspected monkeypox infection)	• High risk of vertically transmitted monkeypox infection
	• Swabs of skin, oropharynx, and rectum for MPXV-PCR
	• Consider empirical treatment with intravenous vaccinia immune globulin in consultation with neonatal and infectious disease specialists
	• Monitor for skin, eye, and mucous membrane lesions, irritability, and poor feeding
	• Consider reuniting mother and infant if both are positive for monkeypox and encourage breastfeeding unless the mother has a monkeypox rash around the nipples

MPXV, monkeypox virus; PCR, polymerase chain reaction.

Dashraath. Monkeypox and pregnancy. Am J Obstet Gynecol 2022.