Abortion in Cases of Zika Virus Congenital Infection

Abstract

The emergency in international public health caused by the Zika virus gave rise to the discussion about abortion in cases of congenital Zika virus syndrome (CZS). Therefore, we propose to carry out a bibliographic review on abortion in these cases. Five databases were searched using the following terms: abortion, miscarriage, and zika, with the interposition of the Boolean operator "AND." In the selected literature, we found references to the lack of information concerning the risks and severity of CZS, to the great psychological distress suffered by pregnant women, and to the risk of unsafe abortions as a justification for abortion in cases of CZS. However, it is necessary to have available tests that could diagnose, in the first trimester of pregnancy, that the fetus has been affected by the virus, and that it may have important limitations, in order to subsidize the qualified discussion about abortion in these cases. Palavras-chave► infecção pelo zika vírus ► aborto ► bioética ResumoA emergência provocada na saúde pública internacional por causa do vírus Zika trouxe à tona a discussão do aborto em casos de síndrome congênita de Zika. Portanto, propomos a realização de uma revisão bibliográfica sobre o aborto nesses casos. Foram pesquisados cinco bancos de dados utilizando os seguintes termos: aborto, aborto espontâneo, e zika, com interposição do operador booleano "E". Na literatura selecionada, encontramos referências à falta de informações sobre os riscos e a gravidade da síndrome congénita de Zika, bem como ao grande sofrimento psicológico de mulheres grávidas e ao risco de aborto inseguro como justificativa para o aborto em casos de síndrome congênita de Zika. No entanto, é necessário ter testes disponíveis que possam diagnosticar, no primeiro trimestre da gravidez, que o feto foi afetada pelo vírus, e que ele pode ter limitações importantes, para subsidiar a discussão qualificada sobre o aborto nesses casos.

Solidarity, vulnerability and mistrust: how context, information and government affect the lives of women in times of Zika

“…1). Few studies in the literature [28][29][30][31] address the experiences of women indirectly affected and less vulnerable to the effects of the Zika epidemic. Our study demonstrate that the social effects of the epidemic affect more women than had been thought before and at deeper levels.…”

“…Social movements to support and defend women's reproductive health rights because of the Zika epidemic might have happened, but many women did not realize that the connection they were fostering with each another might have evolved into a massive push for better access to birth control and better health care services. Surprisingly, women's activism in Brazil and other Latin American countries revolved around the creation of an underground movement for health care -women with children affected by Zika formed non-profit organizations and informal networks to defend their rights [47,48]; abortion activists carried out many activities and studies [2,49,50] in countries where abortion was illegal [29].…”

Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika

“…Individuals' responses to the epidemic depend on the sources of information received, and how these are perceived, which is in turn influenced by broader political, historical, legislative and socioeconomic contexts (Figure 1). Few studies in the literature [31,32,33,34] address the experiences of women indirectly affected and less vulnerable to the effects of the Zika epidemic. Our study demonstrate that the social effects of the epidemic affect more women than had been thought before and at deeper levels.…”

“…Social movements to support and defend women's reproductive health rights because of the Zika epidemic might have happened, but many women did not realize that the connection they were fostering with each another might have evolved into a massive push for better access to birth control and better health care services. Surprisingly, women's activism in Brazil and other Latin American countries revolved around the creation of an underground movement for health care -women with children affected by Zika formed non-profit organizations and informal networks to defend their rights [51,52]; abortion activists carried out many activities and studies [53,54,2] in countries where abortion was illegal [32] .…”

Erythromycin Estolate Inhibits Zika Virus Infection by Blocking Viral Entry as a Viral Inactivator

“…The clinical dosage of Ery-Est for adults is 0.75–2 g/day according to the drug instructions, and it was reported to be safely used by pregnant women at the dosage of 1 g/day to assess whether antibiotic treatment could benefit pregnant women with heavy vaginal ureaplasma colonization [47]. Since it is considered safe in pregnant women, Ery-Est could provide a choice for ZIKV-infected gravida who are most likely to suffer serious consequences of abortion, premature birth, or having a baby with microcephaly [48,49,50,51]. Meanwhile, as the sexual transmission of ZIKV was constantly reported [52,53], Ery-Est also showed great potential to be developed into the microbicide with both anti-ZIKV and bactericidal effects, which would not only block the sexual transmission of ZIKV but would be conducive to the healthy vaginal environment.…”