Obstetric and perinatal outcomes in cases of congenital Zika syndrome

Abstract

Objective: To describe obstetric and perinatal outcomes in cases of congenital Zika syndrome (CZS). Methods: A dual prospective and retrospective cohort study involving 102 pairs of mothers and fetuses/children with CZS whose infection was confirmed by testing for the Zika virus in amniotic fluid, umbilical cord blood, and fragments from the placenta of the newborn infant (confirmed CZS), or by intrauterine imaging tests (neurosonography), and/or postnatal computed tomography (presumed CZS). Results: Suspicion of CZS was investigated by ultrasonography during pregnancy in 52.9% of cases. The principal prenatal imaging findings were ventriculomegaly (43.1%) and microcephaly (42.2%). Median gestational age at delivery was 39 weeks, with 15.7% being premature. Mean head circumference at birth was 30.0 ± 2.3 cm, with 66% of cases being classified as having microcephaly. Arthrogryposis was found in 10 cases (9.8%). There were no fetal deaths; however, nine neonatal deaths were recorded, and three autopsies were performed. Conclusion: Neonatal mortality was high, almost 10%. Regarding the abnormalities of CZS, microcephaly, although common, was not present in all cases and intracranial findings need to be taken into consideration for diagnosis. Therefore, ultrasound screening during pregnancy should be systematized and expanded in endemic zones.

Seroprevalence of Zika virus in pregnant women from central Thailand

“…The abnormalities are generally found in the central nervous system (CNS) such as ventriculomegaly, ventricular/vermis agenesis, abnormal middle cerebral artery flow, visual impairment and microcephaly [10][11][12]. Evidence of morbidity and mortality of fetus in ZKV infected pregnant women have been reported [13].…”

Serious Concern of Congenital Zika Syndrome (CZS) in India: A Narrative Review

“…Furthermore, they found no signs of microcephaly on sonographic examination in any of the newborns of recently delivered women or pregnant women. In contrast, Melo et al documented 4 miscarriages out of 62 cases (6.4%) and 3 intrauterine deaths out of 62 cases (4.8%) during ZIKV infection [ 39 ]. No cases of microcephaly, morbidity, or GBS as a result of the viral infection were found in the expectant mothers themselves.…”

40 years of prenatal diagnosis in 2020

“…In this issue, the authors who were instrumental in alerting the world to the devastating impacts of Zika virus on fetal brain development summarize the latest on obstetric and perinatal outcomes of congenital Zika virus syndrome. 14 We also include two articles on congenital cytomegalovirus (cCMV), the most common perinatal infection and the potentially most preventable cause of sensorineural deafness and cerebral palsy. We asked experts to give us their approach to counseling couples at risk of cCMV, 15 and routine serological screening for CMV, 16 which become even more topical in light of new data on antiviral therapy.…”

“…Other infections that have been with us for years, decades or even centuries, continue to play a major role in pregnancy outcomes today. In this issue, the authors who were instrumental in alerting the world to the devastating impacts of Zika virus on fetal brain development summarize the latest on obstetric and perinatal outcomes of congenital Zika virus syndrome 14 . We also include two articles on congenital cytomegalovirus (cCMV), the most common perinatal infection and the potentially most preventable cause of sensorineural deafness and cerebral palsy.…”