General Practice 2022

Zika vírus in pregnancy: symptoms, risks, diagnosis and treatment

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Zika vírus in pregnancy: symptoms, risks, diagnosis and treatment
Zika vírus in pregnancy: symptoms, risks, diagnosis and treatment

Zika virus infection during pregnancy poses a risk to the baby, because the virus can cross the placenta and reach the baby's brain and compromise its development, resulting in microcephaly and other neurological changes, such as lack of coordination motor and cognitive impairment.

This infection is identified through the signs and symptoms presented by the pregnant woman, such as the appearance of red spots on the skin, fever, pain and swelling in the joints, as well as through tests that must be indicated by the doctor and that allow the identification of the virus

Symptoms of Zika virus in pregnancy

A woman infected with the Zika virus during pregnancy has the same signs and symptoms as everyone else who has been infected with the virus, such as:

  • Red spots on the skin;
  • Body itch;
  • Fever;
  • Headache;
  • Redness in the eyes;
  • Joint pain;
  • Swelling in the body;
  • Weakness.

The incubation period of the virus is 3 to 14 days, that is, the first symptoms begin to appear after this period and normally disappear after 2 to 7 days. However, even if the symptoms disappear, it is important that the woman goes to the gynecologist-obstetrician or infectious disease specialist so that tests are carried out and the risk of transmitting the virus to the baby is verified.

Although the baby's brain impairment is greater when the mother has Zika in the first trimester of pregnancy, the baby can be affected at any stage of pregnancy.Therefore, all pregnant women must be monitored by doctors during prenatal care and must protect themselves from the mosquito to avoid catching Zika, in addition to using condoms when their partner has symptoms of Zika.

Risks and complications for the baby

The Zika virus manages to cross the placenta and reach the baby and, as it has a predilection for the nervous system, it goes to the baby's brain, interfering with its development and resulting in microcephaly, which is characterized by the perimeter of the head less than 33 centimeters. As a consequence of the poor development of the brain, the baby has cognitive deficit, difficulty seeing and lack of motor coordination.

Although the baby can be reached at any stage of pregnancy, the risks are greater when the mother's infection occurs in the first trimesters of pregnancy, this is because the baby is still in the development phase, with a greater risk of miscarriage and death of the baby still in the womb, while in the last trimesters of pregnancy the baby is practically formed, so the virus has less impact.

The only ways to know if the baby has microcephaly are through ultrasound, where a smaller brain circumference can be observed, and by measuring the size of the head as soon as the baby is born. However, no test can prove that the Zika virus was present in the baby's bloodstream at any time during pregnancy. Studies carried out verified the presence of the virus in the amniotic fluid, serum, brain tissue and CSF of newborns with microcephaly, indicating that there was an infection.

How the transmission happens

The main form of transmission of the Zika virus is through the bite of the Aedes aegypti mosquito, however it is also possible that the virus is transmitted from mother to child during pregnancy or at the time of delivery. Cases of transmission of the Zika virus through unprotected sexual contact have also been described, but this form of transmission still needs to be further studied in order to be confirmed.

How the diagnosis is made

The diagnosis of Zika in pregnancy must be made by the doctor based on the evaluation of the signs and symptoms presented by the person, as well as by carrying out some tests. It is important that the tests are carried out during the period of symptoms, with a greater probability of identifying the circulating virus.

The 3 main tests that are able to identify that a person has Zika are:

1. PCR molecular test

The molecular test is the most used to identify Zika virus infection, because in addition to indicating the presence or absence of infection, it also informs the amount of circulating virus, which is important for the indication of treatment by the doctor.

PCR can identify virus particles in blood, placenta and amniotic fluid. The result is more easily obtained when it is performed while the person has symptoms of the disease, which varies between 3 and 10 days.After this period, the immune system fights the virus and the less virus present in these tissues, the more difficult it will be to reach a diagnosis.

When the result is negative, which means that no Zika virus particles were found in the blood, placenta or amniotic fluid, but the baby has microcephaly, other causes of this disease should be investigated. Know the causes of microcephaly.

However, it is difficult to know whether the woman has had Zika for so long that the immune system has managed to remove all traces of the virus from her body. This could only be clarified by carrying out another test that evaluates the antibodies formed against the Zika virus, which so far does not exist, although researchers around the world are working in this direction.

2. Quick Test for Zika

The rapid test for Zika is done with the objective of screening, since it only indicates whether or not there is infection from the evaluation of antibodies circulating in the body against the virus.In the case of positive results, a molecular test is indicated, while in the case of negative tests, the recommendation is to repeat the test and, if there are symptoms and the rapid test is negative, the molecular test is also indicated.

3. Differential exam for Dengue, Zika and Chikungunya

As Dengue, Zika and Chikungunya cause similar symptoms, one of the tests that can be performed in the laboratory is the differential test for these diseases, which consists of specific reagents for each of the diseases and provides the result in more or less less than 2 hours.

See more about Zika diagnosis.

How to protect yourself from Zika in pregnancy

To protect yourself and avoid Zika, pregnant women should wear long clothes that cover most of the skin and use repellent every day to keep mosquitoes away. See which repellants are the most recommended during pregnancy.

Other strategies that may be helpful are planting citronella or lighting citronella scented candles nearby because they keep mosquitoes away.Investing in the consumption of foods rich in vitamin B1 also helps to keep mosquitoes away because it changes the smell of the skin, making mosquitoes not attracted to your scent.

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