Zika virus (ZIKV) belongs to the family of flaviviruses and is transmitted by mosquitoes of the genus Aedes (A. aegypti and A. albopictus). ZIKV infection in pregnancy can have serious implications on the fetus and the neonate. Vertical transmission to the fetus can occur irrespective of symptomatic or asymptomatic infection in the pregnant woman and the risk can persist throughout pregnancy. The exact frequency of maternal-to-fetal transmission of Zika virus is difficult to determine accurately. The greatest risk of serious fetal sequelae is seen if the infection occurs within the first and second trimester. However, they can also be seen with infections in the third trimester. This document describes the presentation, fetomaternal manifestations, role of prenatal Ultrasound in diagnosis of infection, testing methods and the management in pregnancy and screening in the neonatal period. In the absence of robust evidence as to the definite effects, this document is aimed at providing practice recommendations for the management of this infection.
The authors present a case of prenatally diagnosed fetal terminal 4q deletion in the cytoband 4q33q35.2, inherited from the mother. The index pregnancy was referred at 28
+2
weeks of gestation for polyhdramnios. Prior to performing the scan, distinctive facial features were noted in the mother. Target scan confirmed polyhdramnios, and revealed fetal retrognathia. The fetal karyotype reported a terminal 4q33>ter deletion, which was further delineated by chromosomal microarray analysis. Subsequently, maternal karyotype revealed identical deletion. Subtle fetal ultrasound abnormalities should receive meticulous assessment, and evaluation using the currently available wide range of cytogenetic and molecular gene tests.
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