Abstract
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.
Highlights
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
Recent studies have suggested a strong association of maternal infection by Zika virus with fetal anomalies, of the brain, highlighting microcephaly,[2,3,9,10] as an association recognized by the Centers for Disease Control and Prevention of being a major public health problem.[11]
Has been taken in consideration when a newborn is born with the head circumference (HC) below the curve pattern appropriate for the age and gender using reference tables.[12,13,14]
Summary
Recent studies have provided strong evidence of the association between the infection of Zika virus (ZIKV) during pregnancy and the development of microcephaly.[1,2,3,4,5] The virus is transmitted by mosquitoes, the Aedes species,[4] by direct transmission among humans, perhaps sexual intercourse, and as perinatal, all have been described.[1,6]Serious consequences of arboviruses transmission to maternal-fetal have been reported, in for Chikungunya (as being associated to hemorrhagic fever and encephalopathy) and dengue (leading to premature delivery, fetal death, low birth weight, fetal abnormalities, prematurity and acute fetal distress).[7,8] until this moment there are no reports in the medical literature associating Zika virus with congenital anomalies, microcephaly.[2]Recent studies have suggested a strong association of maternal infection by Zika virus with fetal anomalies, of the brain, highlighting microcephaly,[2,3,9,10] as an association recognized by the Centers for Disease Control and Prevention of being a major public health problem.[11]Microcephaly has been taken in consideration when a newborn is born with the head circumference (HC) below the curve pattern appropriate for the age and gender using reference tables.[12,13,14] the diagnosis of this event during pregnancy is not accurate and is defined as the cephalic circumference (CC) is measured by ultrasound (USG) and is found to be less than two or three standard deviation below the mean for gestational age.[12,15,16]. Recent studies have provided strong evidence of the association between the infection of Zika virus (ZIKV) during pregnancy and the development of microcephaly.[1,2,3,4,5] The virus is transmitted by mosquitoes, the Aedes species,[4] by direct transmission among humans, perhaps sexual intercourse, and as perinatal, all have been described.[1,6]. Recent studies have suggested a strong association of maternal infection by Zika virus with fetal anomalies, of the brain, highlighting microcephaly,[2,3,9,10] as an association recognized by the Centers for Disease Control and Prevention of being a major public health problem.[11].
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