Comprehensive Review of Treatment Approaches for Cutaneous Leishmaniasis in Pregnant Women: Evaluating Maternal Health Risks, Safety Considerations, and Therapeutic Strategies

Introduction: Cutaneous Leishmaniasis (CL) is a vector-borne parasitic disease that causes skin lesions and can have significant impacts on public health in endemic regions. While CL primarily affects the skin, its presence during pregnancy raises concerns regarding maternal and fetal health. The treatment of CL in pregnant women presents unique challenges due to the limited availability of safe and effective therapeutic options. This review aims to explore the available treatment modalities for CL in pregnant women, assess the associated risks to maternal health, and evaluate current therapeutic strategies. Methods: A comprehensive review of the literature was conducted using PubMed, Scopus, and web of science databases, focusing on studies published between ۲۰۰۰ and ۲۰۲۴. We included clinical trials, observational studies, and case reports that addressed the treatment of CL in pregnant women, with an emphasis on safety profiles, maternal health risks, and therapeutic outcomes. Findings: Several treatment options for CL, including antimonial compounds (e.g., sodium stibogluconate), miltefosine, and topical therapies (e.g., paromomycin), are commonly used. However, the safety of these treatments during pregnancy is not well-established. Sodium stibogluconate and miltefosine, while effective, are associated with potential risks such as fetal harm and teratogenic effects, leading to recommendations for caution or avoidance during pregnancy. In contrast, topical treatments like paromomycin appear to be safer alternatives, with limited systemic absorption. Other experimental therapies, such as immunotherapy and photodynamic therapy, are being investigated, but their application in pregnant women remains limited due to lack of sufficient clinical data. The challenge remains in balancing the efficacy of these treatments with the potential risks to maternal and fetal health. Conclusion: The treatment of Cutaneous Leishmaniasis in pregnant women requires a careful assessment of risks and benefits. While certain systemic therapies pose potential risks to maternal health and fetal development, topical treatments offer safer alternatives. Further research is needed to develop safer, more effective treatment protocols for pregnant women with CL. Clinicians must adopt a case-by-case approach, considering the severity of the disease, the stage of pregnancy, and the potential consequences of untreated CL on both maternal and fetal health.

کلیدواژه ها:

Cutaneous Leishmaniasis ، Pregnant women ، Maternal health