 Thank you, organizer. Thank you all for giving me the occasion to speak about, unfortunately, a topic that is very much nowadays, again, in the media with the new outbreak in DRC. I'll speak about survival of pregnant women in the West Africa Ebola outbreak. So historically, pregnancy and Ebola looked like a palliative disease for the mother. There's 90% mortality out of the two large studies being described in the literature, one from 40 years ago and one from 20 years ago. Also, the mortality for the fetus and for the baby, because some babies were born alive, is 100%. 15 babies were historically born alive, but all died within 21 days of presumably Ebola. So what we wanted to know in the West Africa outbreak, first of all, what is the maternal and neonatal survival of Ebola viral disease? Secondly, also, does pregnancy worsen your prognosis? Because this was also not clear from previous outbreaks. And thirdly, what is the potential infectiousness of amniotic fluid or products of conception after birth? So all nine study sites, MSF managed Ebola treatment centers reported pregnant patients between 1 and 18 per site, two were in Guinea, five were in Sierra Leone, and two were in Liberia. And they reported over a time period of a year and a half. And after the epidemic, also, a manual retrospective patients' file search was done in order to retrieve any missing patients. And what we also did was we compared survival in Ebola-confirmed pregnant women versus Ebola-confirmed clinically and amnestically non-pregnant women of reproductive age. And I'll mention already one of the limitations. Only in a very small minority of women of reproductive age, actually, a pregnancy test was done. So there are definitely women in this group of reproductive age who were pregnant, but it was not noticed by the treating physician or the patient didn't know. So about the West Africa outbreak, in total, there were almost 30,000 cases, but this was suspected, probable, and confirmed together. So the confirmed were 15,227, and MSF treated almost 1 third of all the confirmed patients, almost 5,000. And of those 5,000, 4,000 files were available for analysis, 80% of files. Of those 4,000 patients, 77 women were confirmed pregnant or clinically or a pregnancy test done. And we compared them with a group of 1,204 women of reproductive age who were clinically and amnestically non-pregnant. And in a small minority, it was also a pregnancy test done. 77 out of 4,000, this is 1.9%. This is not enough. We missed also a lot of pregnant women. According to population figures, you would expect in the affected countries around between 4% and 5% of the general population who is pregnant. So what did we find? Of these 77 pregnant Ebola confirmed positive women, 41 died. This was 53%. 22 died undelivered, 18 delivered or miscarried before death, and of one that we don't know if the patient delivered or miscarried before death. 36 of them survived. This is almost 47%. 23 delivered or miscarried before or during admissions. Eight were inductions for intrauterine fetal death. We also did three terminations of pregnancy in the Ebola treatment center. One of the options discussed with the patient, if she was convalescent, if she was cured from Ebola, is what she wanted to do with the pregnancy or the fact she and the family. Because the family was also very important in the decision process. One patient delivered at home, a macerated stillbirth. And of one patient, the first time as a pregnancy, we don't know what happened to the pregnancy. So we compared this to the survival of women of reproductive age in the Ebola treatment center. And the survival rate of them was 50.4%. And this was clinically, I'm sorry, this was statistically not different from pregnant women with Ebola viral disease. The survival of pregnant patients was associated, as you would expect, because this is the same for the general population, with the lower viral load at admission. The lower your viral load, the highest your chance of survival. And this is very strongly associated. And what we also saw was, if you're in the first trimester, you are more likely to survive than if you are in the third trimester of pregnancy. Although this is small numbers, we had 16 first trimester pregnancies, of which 12 survived, and 28 third trimester pregnancies, of which 10 survived. Why we can expand more in the questions? Probably because of the physiological changes of pregnancy, if you are in the third trimester pregnant, and you have Ebola, and you still need to deliver, of course, you will bleed more than with the first trimester miscarriage. And it might also be that because we did do, at the end of the epidemic, pregnancy testing of women of reproductive age, but we usually did it when the patient was already recovering. So it might be for the first trimester pregnancies that were picked up with a pregnancy test that we sort of had a survival testing bias. What we also found was, we did PCR testing on amniotic fluid in some fetuses on fetal cord blood, placenta as products of conception. And we did this in 22 deliveries and abortions. And in all cases, at least one PCR was positive. And in most cases, PCR was strongly positive less than 25. And this also between zero, the patient still was Ebola positive, until 32 days after negativation of the maternal blood PCR. So the patient had already recovered more than a month from Ebola, but still the amniotic fluid remained PCR positive. We had one baby born in Gekedu, Guinea, who lived for two days and who died of, unfortunately, Ebola. The baby had a PCR of 26 at birth, was clinically well, but deteriorated fast and died two days later with a CT value of 13. And we had one survivor of congenital Ebola viral disease. This baby is known, and the father gave us permission to use her name as Nubia. The family called the baby Nubia because there was a Brazilian nurse called Nubia taking care of the baby. Unfortunately, Nubia lost her mother, but she's now two years and a half, and she's alive and well. So to conclude, we have many limitations. I can write a paper about the limitations of the study. First of all, 20% of the files was not available for analysis. Secondly, these patients were treated in three different countries in nine different Ebola treatment centers, and over a time period of almost two years with also epidemiological changes, with changes in workload. Thirdly, also, we didn't do standard pregnancy testing until the end of the epidemic. And also, fourthly, some of the patients received experimental drugs. In the convalescent plasma trial in Guinea, pregnancy was not an exclusion criterion, and eight patients were in the trial. And also, the mother of Nubia received Favipiravir, another experimental drug. But most pregnant patients did not receive experimental drugs. Then there was no statistical difference in survival when compared with non-pregnant, or at least clinically and amnestically, non-pregnant women of reproductive age. Our survival was markedly better than historical data on Ebola viral disease and pregnancy. And we found, and this is also new information of the West Africa epidemic, that also amniotic fluid remains persistent CT positive after convalescence of the mother. The same is very well known in male survivors, that their semen remains a long time positive. We found up to 32 days. We don't know if CT positivity equals infectivity, because cultures were not done. And we had Nubia, the first documented survivor of congenitally acquired Ebola. From this study, four operational recommendations came out. And these recommendations, unfortunately, for the Congolese population, we will try to put in place. First of all, we want standard pregnancy testing at admission for all women of reproductive age, both for themselves and their families, that they know they are pregnant. As also, if they are discharged and the products of conception are still PCR positive, it might be a risk for the person doing the delivery, or if she miscarries at home. Secondly, all pregnant Ebola positive or convalescent patients should deliver inside the Ebola treatment center, awaiting more research on infectivity. Thirdly, we should foresee a private maternity space in the Ebola treatment center, if possible, for the mother, and also to have a box for a potentially alive neonates. We had the baby surviving. And also, the management of patients with ongoing pregnancies after convalescence of the mother in the Ebola treatment center remains a challenge. I cannot give a black or white answer what to do with the pregnancy, involvement of the patient, what she wants to do, what the family wants to do, and a very good discussion is needed. And then to conclude, I would like to show this picture. This is Nubia at seven months. I'd like to thank Armar Sprecher, because I took the picture from him. And I'd like to thank everybody who cared for the patients and who reported data during the epidemic. Thank you. And I'd like to thank the three ministries of Health of the affected countries. Thank you. Thank you. Thank you.