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A review of Zika virus infections in pregnancy and implications for antenatal care in Singapore.

Abstract
Given the consensus that there is a causal relationship between Zika virus (ZIKV) infection in pregnancy and congenital Zika syndrome (CZS), clinicians must be prepared to manage affected patients despite the numerous gaps in current knowledge. The clinical course in pregnancy appears similar to that in non-pregnant women, although viraemia may be prolonged. ZIKV infection can be diagnosed by serum and urine reverse transcription-polymerase chain reaction, but commercially available serological tests are currently unreliable in dengue-endemic regions. Although vertical transmission can occur at any time during gestation, first- and second-trimester infections have the highest risk of developing central nervous system anomalies. Aberrant fetal growth and pregnancy loss may also occur. Serial ultrasonography should be conducted for infected cases. Without a vaccine, pregnant women should be advised to minimise mosquito bites and reduce sexual transmission risk. Overall, the absolute risk of CZS arising amid a ZIKV outbreak appears relatively low.
AuthorsHarvard Zhenjia Lin, Paul Anantharajah Tambyah, Eu Leong Yong, Arijit Biswas, Shiao-Yng Chan
JournalSingapore medical journal (Singapore Med J) Vol. 58 Issue 4 Pg. 171-178 (Apr 2017) ISSN: 2737-5935 [Electronic] India
PMID28429036 (Publication Type: Journal Article, Review)
CopyrightCopyright: © Singapore Medical Association.
Topics
  • Aedes (virology)
  • Animals
  • Brazil
  • Disease Outbreaks
  • Female
  • Humans
  • Infectious Disease Transmission, Vertical (prevention & control)
  • Insect Bites and Stings (prevention & control, virology)
  • Insect Vectors (virology)
  • Nervous System Malformations (diagnostic imaging, virology)
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious (prevention & control, urine, virology)
  • Prenatal Care (methods)
  • Singapore
  • Zika Virus (isolation & purification)
  • Zika Virus Infection (complications, prevention & control, transmission, urine)

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