Zika and Pregnancy: Critical Facts Every Expectant Mother Should Know - Dr Kinjal Avdhut Kothari

Zika virus, a mosquito-borne flavivirus, garnered global attention in recent years due to its association with severe birth defects in infants born to mothers infected during pregnancy. This article aims to provide comprehensive insights into Zika and pregnancy, covering essential facts, risks, prevention strategies, and management guidelines.

Understanding Zika Virus

The primary method of transmission of the Zika virus is by the bite of an infected Aedes mosquito, specifically Aedes aegypti and Aedes albopictus.

In addition to mosquito bites, Zika can also spread through sexual contact and from mother to fetus during pregnancy or around the time of birth.

Symptoms of Zika infection in adults are usually mild and include fever, rash, joint pain, and conjunctivitis. However, the virus poses significant risks during pregnancy, as it can cause congenital disabilities in the developing fetus.

Risks to the Fetus

The most alarming consequence of Zika virus infection during pregnancy is its association with congenital Zika syndrome (CZS). CZS encompasses a range of severe birth defects, including microcephaly (a condition where a baby's head is smaller than expected), brain damage, eye abnormalities, and other neurological impairments. These defects can result in lifelong disabilities and developmental delays for the affected child.

Transmission and Timing of Infection

Zika virus can be transmitted from a pregnant woman to her fetus during pregnancy or around the time of birth. The virus can also be sexually transmitted, even if the infected partner does not exhibit symptoms at the time of transmission. It's important to note that Zika virus can persist in semen longer than in other bodily fluids, posing a prolonged risk of transmission via sexual contact.

Geographic Distribution and Travel Recommendations

Zika virus is endemic in tropical and subtropical regions, including parts of Africa, Asia, the Pacific Islands, and the Americas. Travellers, especially pregnant women, should be aware of areas with ongoing Zika transmission and take precautions to avoid mosquito bites.

The Centers for Disease Control and Prevention (CDC) regularly updates travel advisories related to Zika virus, recommending strict adherence to preventive measures.

Preventive Measures

Preventing Zika virus infection is crucial for pregnant women and those planning pregnancies. Key preventive measures include:

1. Mosquito Bite Prevention: Use insect repellents containing DEET, wear long-sleeved shirts and pants, and stay in places with air conditioning or window and door screens.

2. Safe Sexual Practices: Pregnant women with partners who have travelled to or reside in Zika-affected areas should practice safe sex or abstain from sexual activity throughout the pregnancy.

3. Avoiding Travel to Affected Areas: Consider postponing travel to regions with active Zika transmission, especially during pregnancy.

Diagnosis and Screening

Early detection of Zika virus infection in pregnant women is crucial for timely management and monitoring of fetal health. Healthcare providers may recommend testing for Zika virus if a pregnant woman has travelled to or resides in an area with Zika transmission, or if she has had unprotected sexual contact with someone who has travelled to such an area.

Management and Follow-Up

If a pregnant woman tests positive for Zika virus, close monitoring and specialized care are essential throughout the pregnancy. This includes regular ultrasounds and other diagnostic tests to assess fetal development and detect any signs of CZS. Obstetricians and maternal-fetal medicine specialists play a critical role in coordinating care and providing support to expectant mothers and their families.

In conclusion, Zika virus infection during pregnancy poses significant risks to maternal and fetal health, potentially leading to severe birth defects and developmental disabilities. As a gynaecologist, it is paramount to educate expectant mothers about the preventive measures, risks, and management strategies associated with Zika virus.

By staying informed and taking necessary precautions, pregnant women can minimize the risk of Zika virus infection and ensure the best possible outcomes for themselves and their babies.

As research continues to evolve, ongoing vigilance and adherence to public health recommendations are essential in addressing the challenges posed by the Zika virus in pregnancy. By working together with healthcare providers and public health authorities, we can empower expectant mothers to make informed decisions and protect the health and well-being of themselves and their children.