Luz Ángela Gutiérrez-Sánchez1,2,3, Carlos Hernán Becerra-Mojica1,2,4, Mario Augusto Rojas1,5, Luis Alfonso Díaz-Martínez1,6, Luis Alfonso Pérez Vera1,5, Gustavo Adolfo Contreras García1, Luz Stella Pinilla García1. 1. School of Medicine, Health Faculty, Universidad Industrial de Santander, Bucaramanga, Colombia. 2. Maternal-Fetal Medicine Unit, Hospital Universitario de Santander, Bucaramanga, Colombia. 3. Clínica Materno Infantil San Luis, Bucaramanga, Colombia. 4. Fundación Oftalmológica de Santander, Clínica Carlos Ardila Lülle, Bucaramanga, Colombia. 5. Colombian Association of Neonatology, Colombian Neonatal Research Network, Bogotá, Colombia. 6. Neonatal Unit, Hospital Universitario de Santander, Bucaramanga, Colombia.
Abstract
INTRODUCTION: In October 2015, an epidemic of Zika began in Colombia's geographic areas with a high population of mosquitoes of the genus Aedes. We aimed to describe the fetal brain ultrasound findings in pregnant women with active symptoms or a history of symptoms suggestive of Zika virus (ZIKV) infection. MATERIAL AND METHODS: Eligible pregnant women were tested with reverse transcriptase-polymerase chain reaction (RT-PCR) for ZIKV and followed prospectively using detailed anatomic ultrasound and transvaginal neurosonography to detect structural anomalies of the fetal central nervous system (CNS). RESULTS: A total of 115 symptomatic women with a positive ZIKV RT-PCR and 55 with a negative ZIKV RT-PCR were enrolled in the study; CNS compromise of the fetus occurred in 22% and 17%, respectively (p = 0.255). Callosal dysgenesis (14.5%) was the most frequent anomaly of the CNS, followed by microcephaly (13.6%) and neuronal migration disorders (8.3%). When symptomatic ZIKV RT-PCR-positive women were categorized by trimester of infection, CNS anomalies were present in 40% of first-trimester infections, compared with 21% and 7% in second- and third-trimester infections (p = 0.002). CNS anomalies were also more severe in first-trimester-infected fetuses than in second- and third-trimester-infected fetuses. The high prevalence of CNS anomalies in fetuses of symptomatic ZIKV RT-PCR negative women suggests a high rate of false-negative cases and an even higher prevalence of CNS anomalies than observed in this study. CONCLUSIONS: The prevalence of fetal CNS anomalies was higher than previously reported in the literature for both symptomatic RT-PCR-positive and -negative pregnant women. Corpus callosum anomalies, microcephaly, neuronal migration disorders, and brain parenchymal hyperechogenicities were the most frequent CNS anomalies detected. In addition, CNS anomalies were more frequent and severe in infected fetuses during the first trimester of pregnancy than during the second or third trimester.
INTRODUCTION: In October 2015, an epidemic of Zika began in Colombia's geographic areas with a high population of mosquitoes of the genus Aedes. We aimed to describe the fetal brain ultrasound findings in pregnant women with active symptoms or a history of symptoms suggestive of Zika virus (ZIKV) infection. MATERIAL AND METHODS: Eligible pregnant women were tested with reverse transcriptase-polymerase chain reaction (RT-PCR) for ZIKV and followed prospectively using detailed anatomic ultrasound and transvaginal neurosonography to detect structural anomalies of the fetal central nervous system (CNS). RESULTS: A total of 115 symptomatic women with a positive ZIKV RT-PCR and 55 with a negative ZIKV RT-PCR were enrolled in the study; CNS compromise of the fetus occurred in 22% and 17%, respectively (p = 0.255). Callosal dysgenesis (14.5%) was the most frequent anomaly of the CNS, followed by microcephaly (13.6%) and neuronal migration disorders (8.3%). When symptomatic ZIKV RT-PCR-positive women were categorized by trimester of infection, CNS anomalies were present in 40% of first-trimester infections, compared with 21% and 7% in second- and third-trimester infections (p = 0.002). CNS anomalies were also more severe in first-trimester-infected fetuses than in second- and third-trimester-infected fetuses. The high prevalence of CNS anomalies in fetuses of symptomatic ZIKV RT-PCR negative women suggests a high rate of false-negative cases and an even higher prevalence of CNS anomalies than observed in this study. CONCLUSIONS: The prevalence of fetal CNS anomalies was higher than previously reported in the literature for both symptomatic RT-PCR-positive and -negative pregnant women. Corpus callosum anomalies, microcephaly, neuronal migration disorders, and brain parenchymal hyperechogenicities were the most frequent CNS anomalies detected. In addition, CNS anomalies were more frequent and severe in infected fetuses during the first trimester of pregnancy than during the second or third trimester.
Authors: Luis Alfonso Díaz-Martínez; Mario Augusto Rojas; Luz Stella Pinilla-García; Carlos Hernán Becerra-Mojica; Luis Alfonso Pérez-Vera; Luz Ángela Gutiérrez-Sánchez; Gustavo Adolfo Contreras-García; Carol Gisela Rueda-Ordoñez; Luis Villar Journal: PLoS Negl Trop Dis Date: 2022-03-07
Authors: Kathia Guardado; Miguel Varela-Cardoso; Verónica Ofelia Pérez-Roa; Jaime Morales-Romero; Roberto Zenteno-Cuevas; Ángel Ramos-Ligonio; Oscar Guzmán-Martínez; Clara L Sampieri; Christian S Ortiz-Chacha; Rosybet Pérez-Varela; Cristina Fernanda Mora-Turrubiate; Hilda Montero Journal: Children (Basel) Date: 2022-08-12