Download PDF
Semin Reprod Med 2016; 34(05): 280-284
DOI: 10.1055/s-0036-1592073
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prenatal Effects of Zika Virus and Management of the Pregnant Woman

Solange N. Eloundou
1   Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Jeanne S. Sheffield
1   Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

Publication Date:
09 September 2016 (online)

    Permissions and Reprints

Abstract

The identification of Zika virus as a significant teratogen has raised international concern, causing the World Health Organization to declare a Public Health Emergency of International Concern. This has allowed a global mobilization of experts in tropical infectious diseases, obstetrics, pediatrics, virology, public health policy, reproductive health, bioethics, and germ cell research to name just a few. This worldwide crisis has also raised awareness of health care disparities and concerns regarding the ability of families and societies to shoulder the long-term financial burden that the follow-up of affected children will require. There is now strong biologic evidence of causality between Zika virus and microcephaly and other neurologic abnormalities identified. Multiple national and international organizations have collaborated to develop guidelines for the management of pregnant women who reside in or who are exposed to Zika virus, whether from travel to affected areas or via sexual contact with an infected individual. These guidelines are updated frequently as data are made available. Testing algorithms are available and though testing is fraught with interpretation issues, the development of better diagnostic tests is ongoing.

Keywords

Zika virus - pregnancy - microcephaly - perinatal infection
 

  • References

  • 1 Duffy MR, Chen TH, Hancock WT , et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009; 360 (24) 2536-2543
    CrossrefPubMedGoogle Scholar
  • 2 Cauchemez S, Besnard M, Bompard P , et al. Association between Zika virus and microcephaly in French Polynesia, 2013-15: a retrospective study. Lancet 2016; 387 (10033) 2125-2132
    CrossrefPubMedGoogle Scholar
  • 3 Pan American Health Organization. World Health Organization. Epidemiological alert: neurological syndrome, congenital malformations and Zika virus infection. Implications for public health in the Americas. December 1, 2015. Available at: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32405&lang=en . Accessed July 1, 2016
    PubMedGoogle Scholar
  • 4 Hills SL, Russell K, Hennessey M , et al. Transmission of Zika virus through sexual contact with travelers to areas of ongoing transmission-Continental United States 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (8) 215-216
    CrossrefPubMedGoogle Scholar
  • 5 Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis 2015; 21 (2) 359-361
    CrossrefPubMedGoogle Scholar
  • 6 Driggers RW, Ho CY, Korhonen EM , et al. Zika virus infection with prolonged maternal viremia and fetal brain abnormalities. N Engl J Med 2016; 374 (22) 2142-2151
    CrossrefPubMedGoogle Scholar
  • 7 Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg?. Ultrasound Obstet Gynecol 2016; 47 (1) 6-7
    CrossrefPubMedGoogle Scholar
  • 8 Mlakar J, Korva M, Tul N , et al. Zika virus associated with microcephaly. N Engl J Med 2016; 374 (10) 951-958
    CrossrefPubMedGoogle Scholar
  • 9 Brasil P, Pereira Jr JP, Raja Gabaglia C , et al. Zika virus infection in pregnant women in Rio de Janeiro - preliminary report. N Engl J Med 2016; doi 10.1056/NEJMoa1602412
    PubMedGoogle Scholar
  • 10 Oduyebo T, Petersen EE, Rasmussen SA , et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure — United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (5) 122-127
    CrossrefPubMedGoogle Scholar
  • 11 Petersen EE, Polen KN, Meaney-Delman D , et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure — United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (12) 315-322
    CrossrefPubMedGoogle Scholar
  • 12 Petersen EE, Staples JE, Meaney-Delman D , et al. Interim guidelines for pregnant women during a Zika virus outbreak - United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (2) 30-33
    CrossrefPubMedGoogle Scholar
  • 13 Reefhuis J, Gilboa SM, Johansson MA , et al. Projecting month of birth for at-risk infants after Zika virus disease outbreaks. Emerg Infect Dis 2016; 22 (5) 828-832
    CrossrefPubMedGoogle Scholar
  • 14 Practice Advisory: Updated Interim Guidance for Care of Women of Reproductive Age During a Zika Virus Outbreak. February 2016. Available at: http://www.acog.org/About-ACOG/News-Room/Practice-Advisories/Practice-Advisory-Interim-Guidance-for-Care-of-Obstetric-Patients-During-a-Zika-Virus-Outbreak . Accessed July 1, 2016
    PubMedGoogle Scholar
  • 15 Oster AM, Russell K, Stryker JE , et al. Update: Interim Guidance for prevention of sexual transmission of Zika virus - United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (12) 323-325
    CrossrefPubMedGoogle Scholar
  • 16 Infant feeding in areas of active Zika virus transmission. World Health Organization. Summary of rapid advice guideline. June 29, 2016. Available at: http://apps.who.int/iris/bitstream/10665/204473/1/WHO_ZIKV_MOC_16.5_eng.pdf?ua=1 . Accessed July 1, 2016
    PubMedGoogle Scholar
  • 17 Meaney-Delman D, Rasmussen SA, Staples JE , et al. Zika virus and pregnancy; what obstetric health care providers need to know. Obstet Gynecol 2016; 127 (4) 642-648
    CrossrefPubMedGoogle Scholar
  • 18 Chibueze EC, Tirado V, da Silva Lopes K , et al. Zika virus infection in pregnancy: a systematic review of disease course and complications. Bull World Health Organ 2016; E-pub: 9 June 2016. doi: http://dx.doi.org/10.2471/BLT.16.178426
    PubMedGoogle Scholar
  • 19 Simeone RM, Shapiro-Mendoza CK, Meaney-Delman D , et al; Zika and Pregnancy Working Group. Possible Zika virus infection among pregnant women-United States and Territories, May 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (20) 514-519
    CrossrefPubMedGoogle Scholar
  • 20 Reyna-Villasmil E, López-Sánchez G, Santos-Bolívar J. [Guillain-Barré syndrome due to Zika virus during pregnancy]. Med Clin (Barc) 2016; 146 (7) 331-332
    CrossrefPubMedGoogle Scholar
  • 21 Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WT , et al. Increase in reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy - Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016; 65 (9) 242-247
    CrossrefPubMedGoogle Scholar
  • 22 Schuler-Faccini L, Ribeiro EM, Feitosa IM , et al; Brazilian Medical Genetics Society–Zika Embryopathy Task Force. Possible association between Zika virus infection and microcephaly - Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016; 65 (3) 59-62
    CrossrefPubMedGoogle Scholar
  • 23 França GVA, Schuler-Faccini L, Oliveira WK , et al. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. Lancet 2016;
    PubMedGoogle Scholar
  • 24 de Paula Freitas B, de Oliveira Dias JR, Prazeres J , et al. Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador, Brazil. JAMA Ophthalmol 2016; 134 (5) 529-535
    CrossrefPubMedGoogle Scholar
  • 25 Calvet G, Aguiar RS, Melo AS , et al. Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. Lancet Infect Dis 2016; 16 (6) 653-660
    CrossrefPubMedGoogle Scholar
  • 26 Tang H, Hammack C, Ogden SC , et al. Zika virus infects human cortical neural progenitors and attenuates their growth. Cell Stem Cell 2016; 18 (5) 587-590
    CrossrefPubMedGoogle Scholar
  • 27 Nguyen HN, Qian X, Song H, Ming GL. Neural stem cells attacked by Zika virus. Cell Res 2016; 26 (7) 753-754
    CrossrefPubMedGoogle Scholar
  • 28 Carneiro LA, Travassos LH. Autophagy and viral diseases transmitted by Aedes aegypti and Aedes albopictus . Microbes Infect 2016; 18 (3) 169-171
    CrossrefPubMedGoogle Scholar
  • 29 Miner JJ, Cao B, Govero J , et al. Zika virus infection during pregnancy in mice causes placental damage and fetal demise. Cell 2016; 165 (5) 1081-1091
    CrossrefPubMedGoogle Scholar
  • 30 Interim guidance for Zika virus testing of urine - United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (18) 474
    CrossrefPubMedGoogle Scholar
  • 31 Rabe IB, Staples JE, Villanueva J , et al; MTS. Interim guidance for interpretation of Zika virus antibody test results. MMWR Morb Mortal Wkly Rep 2016; 65 (21) 543-546
    CrossrefPubMedGoogle Scholar
  • 32 Koren G, Matsui D, Bailey B. DEET-based insect repellents: safety implications for children and pregnant and lactating women. CMAJ 2003; 169 (3) 209-212
    PubMedGoogle Scholar
  • 33 Environmental Protection Agency. Repellent treated clothing. Available at: http://www.epa.gov/insect-repellents/repellent-treated-clothing . Accessed July 1, 2016
    PubMedGoogle Scholar
  • 34 Centers for Disease Control and Prevention. Insect repellent use and safety. Available at: http://www.cdc.gov/westnile/faq/repellent.html . Accessed July 1, 2016
    PubMedGoogle Scholar
  • 35 Centers for Disease Control and Prevention. Preconception counseling: for women and men living in areas with ongoing spread of Zika virus who are interested in conceiving. Atlanta (GA): CDC; 2016. Available at: http://www.cdc.gov/zika/pdfs/preconception-counseling.pdf . Accessed July 1, 2016
    Google Scholar
  • 36 Centers for Disease Control and Prevention. Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. CDC Health Advisory. Atlanta (GA): CDC; 2016. Available at: http://emergency.cdc.gov/han/han00385.asp . Accessed July 1, 2016
    Google Scholar
  • 37 Olson CK, Iwamoto M, Perkins KM , et al. Preventing transmission of Zika virus in labor and delivery settings through implementation of standard precautions - United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (11) 290-292
    CrossrefPubMedGoogle Scholar
  • 38 Centers for Disease Control and Prevention. U.S. Zika pregnancy registry. Available at: http://www.cdc.gov/zika/hc-providers/registry.html . Accessed July 1, 2016
    PubMedGoogle Scholar