Francisco Herlânio Costa Carvalho1, Kárita Melo Cordeiro1, Alberto Borges Peixoto2,3, Gabriele Tonni4, Antonio Fernandes Moron3, Francisco Edson Lucena Feitosa1, Helvécio Neves Feitosa1, Edward Araujo Júnior5. 1. Department of Maternal and Child Health, School of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil. 2. Mário Palmério University Hospital-University of Uberaba (UNIUBE), Uberaba, MG, Brazil. 3. Department of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. 4. Department of Obstetrics and Gynecology, Prenatal Diagnostic Center, Guastalla Civil Hospital, Reggio Emilia, Italy. 5. Department of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. araujojred@terra.com.br.
Abstract
OBJECTIVE: To describe fetal ultrasonographic findings and outcomes in a series of cases of fetal microcephaly associated with Zika virus infection. METHODS: Retrospective case series of microcephaly with definite (laboratory evidence) or highly probable (specific neuroimaging findings and negative laboratory results) maternal Zika virus infection. Microcephaly was graded as mild if the head circumference was between 2 and 3 standard deviation (SD) below the mean, and severe if 3 or more SD below the mean. Associated central nervous system (CNS) and extracranial malformations are described. RESULTS: Nineteen singleton pregnancies fulfilling the inclusion criteria were identified. Severe microcephaly and mild microcephaly were identified in 14 and 5 fetuses, respectively. Additional CNS malformations were present in 17 cases and 7 had extracranial congenital anomalies. Symptoms were reported in 13/19 cases at a gestational age between 5 and 16 weeks. Mean (±SD) gestational age at ultrasound diagnosis was 32.3 ± 5.1 weeks. Amniocentesis was performed in five cases at a median gestational age of 31 weeks (range 28-38) and was positive for Zika virus RT-PCR in two cases. There were three neonatal deaths and one stillbirth. CONCLUSION: In the presence of fetal microcephaly associated with Zika virus infection, CNS malformations are frequently detected.
OBJECTIVE: To describe fetal ultrasonographic findings and outcomes in a series of cases of fetal microcephaly associated with Zika virus infection. METHODS: Retrospective case series of microcephaly with definite (laboratory evidence) or highly probable (specific neuroimaging findings and negative laboratory results) maternal Zika virus infection. Microcephaly was graded as mild if the head circumference was between 2 and 3 standard deviation (SD) below the mean, and severe if 3 or more SD below the mean. Associated central nervous system (CNS) and extracranial malformations are described. RESULTS: Nineteen singleton pregnancies fulfilling the inclusion criteria were identified. Severe microcephaly and mild microcephaly were identified in 14 and 5 fetuses, respectively. Additional CNS malformations were present in 17 cases and 7 had extracranial congenital anomalies. Symptoms were reported in 13/19 cases at a gestational age between 5 and 16 weeks. Mean (±SD) gestational age at ultrasound diagnosis was 32.3 ± 5.1 weeks. Amniocentesis was performed in five cases at a median gestational age of 31 weeks (range 28-38) and was positive for Zika virus RT-PCR in two cases. There were three neonatal deaths and one stillbirth. CONCLUSION: In the presence of fetal microcephaly associated with Zika virus infection, CNS malformations are frequently detected.
Authors: Mohammad Zare Mehrjardi; Andrea Poretti; Thierry A G M Huisman; Heron Werner; Elham Keshavarz; Edward Araujo Júnior Journal: Jpn J Radiol Date: 2017-01-10 Impact factor: 2.374
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