No abstract

The Zika virus (ZIKV) epidemic in Brazil occurred in regions where dengue viruses (DENV) are historically endemic. We investigated the differences in adverse pregnancy/infant outcomes in two cohorts comprising 114 pregnant women with PCR-confirmed ZIKV infection in Rio de Janeiro, Southeastern Brazil (n = 50) and Manaus, in the north region of the country (n = 64). Prior exposure to DENV was evaluated through plaque reduction neutralizing antibody assays (PRNT 80) and DENV IgG serologies. Potential associations between pregnancy outcomes and Zika attack rates in the two cities were explored. Overall, 31 women (27%) had adverse pregnancy/infant outcomes, 27 in Rio (54%) and 4 in Manaus (6%), p < 0.001. This included 4 pregnancy losses (13%) and 27 infants with abnormalities at birth (24%). A total of 93 women (82%) had evidence of prior DENV exposure, 45 in Rio (90%) and 48 in Manaus (75%). Zika attack rates differed; the rate in Rio was 10.28 cases/10,000 and in Manaus, 0.6 cases/10,000, p < 0.001. Only Zika attack rates (Odds Ratio: 17.6, 95% Confidence Interval 5.6–55.9, p < 0.001) and infection in the first trimester of pregnancy (OR: 4.26, 95% CI 1.4–12.9, p = 0.011) were associated with adverse pregnancy and infant outcomes. Pre-existing immunity to DENV was not associated with outcomes (normal or abnormal) in patients with ZIKV infection during pregnancy.

No abstract

No abstract

No abstract

No abstract

Background: Malaria acquired during pregnancy is one of the major causes of poor maternal and birth outcomes in tropical areas endemic for this disease. Malaria during pregnancy induces deterioration of placental function, resulting in transient fetal hypoxia and can induces grouth restriction. Ultrassound assessment of intrauterine growth, fetal and Placental abnormalities is often used as a important clinical tool to identify these patological findings.Methods: Fetal biometric mesurements, placental and amniotic fluid evaluation were obtained and thereafter at 4 week intervals from pregnant women enrolled in a longitudinal study.The study population comprised 162 singleton gestations with ultrasound derived gestational age in the first trimester. Estimated fetal biometric parameters and weight were calculated at each ultrasound examination using the Hadlock algorithm. Placental thickness were estimated using Lubschenco data and amniotic fluid was avaliated based in Phelan study.Were included on these study pregnant womens with any Malaria infection in treatment.Were excluded of thete study pregnant womens without treatment, with any patology that can afect fetal growth, and multiple gestations.Results: Fetal growth restriction occured in 7 patients (4%). Placental thickness was increased in 4 patients (2,4%) and decreased in 1(1,2%), 3 pacients had oligodramnious. 1 fetus (1,2%) had bilateral cleft lip detected by ultrasound scan.Conclusion: These datas are against the normal populations datas were the incidence of fetal growth restriction is 3% and fetus malformation 1-2%. This study shows that in a well treated population, the fetal growth can be the same as the population without Malaria. The ultrasonograophy is a good method of fetal, placenta and amniotic fluid evaluation and should be used to folow patologic pregnancy.