Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Abstract

Objectives: to describe altered intrauterine ultrasound, analyze fetal head circumference (HC) growth and neonates' outcomes among presumed cases of congenital Zika syndrome in Brazil. Methods: 30 women were included in the study with suspected history of Zika virus (ZIKV) infection during pregnancy and fetal's brain altered on ultrasound diagnosis. Sociodemographic and obstetric characteristics, prenatal altered ultrasounds, HC and other perinatal outcomes have been described. The relation between HC and gestational age was analyzed by using random regression effects based on polynomials fractions. The Z test was calculated to determine an instant variant mean rate of the HC for each gestational age. Results: the mean gestational age of the ultrasound diagnosis was 33.3 + 4.7 weeks and HC at birth was 28.9 + 1.6 cm. The main altered brain ultrasound was microcephaly (96.7%). The analysis of the fetal head circumference showed an estimated increase of the average HC, as to gestational age, it did not occur in a linear form. The instant HC variation rate increased according to gestational age (p<0,001). Conclusions: Fetal's main morphological alteration was microcephaly, observing an increase in the head circumference according to gestational age in a non-linear form and the variation decreased with gestational age.

Congenital Zika syndrome: A systematic review

“…The most frequent signs observed in imaging tests were located in the central nervous system: ventriculomegaly described in 35 articles [19,23,45 (Table 4). Cardiomegaly and diaphragmatic paralysis were detected by chest x-ray [102].…”

Pregnant women infected by the Zika virus: Ultrasound findings and growth patterns of fetuses with and without microcephaly

“…The most important finding of that study was that the circumference of the brain continued to increase progressively, even after the diagnosis of microcephaly; however, growth was at a slower pace than expected and did not comply with the normal pattern. 4 This reported fetal finding suggests that no head circumference normalization occurs even if the newborn grows.…”

Aedes Aegypti E Arboviroses No Brasil

“…Reforça também que é preciso mais estudos acerca da fisiopatologia dessa infecção. Souza et al (2016a) realizaram um estudo com 30 mulheres na gestação com quadro sugestivo de infecção por Zika vírus, o qual descreveu as características demográficas, sociais, obstétricas, alterações ultrassonográficas intraútero, crescimento da circunferência cefálica (CC) fetal e desfechos neonatais entre casos presumíveis de síndrome da Zika congênita no Brasil. A principal alteração fetal foi quanto à microcefalia, sendo a porcentagem de 96,7%.…”