Zika and pregnancy

In our second installment on the Zika virus we will focus on its effect on pregnant women and what this means for all women.

The Zika virus first gained notoriety when healthcare professionals, public health officers and scientists in Brazil noticed a sharp increase (20 times higher than normal) in the number of babies born with a brain defect called microcephaly in 2015. Babies with microcephaly are born with small deformed heads because the brain stopped developing at a critical point while the baby was still inside the uterus. Because this is such a rare birth defect, scientists started asking questions trying to understand what was going on? Why did we have such an increase in the number of babies born with this defect? Where had their mothers been or what had they been exposed to?

All their questions were answered when they made the connections between Zika virus infection in pregnancy and the presence of the virus in the amniotic fluid. Now we know that when pregnant women are exposed to the Zika virus, it can cross the placenta and affect brain development with the most commonly seen brain defect being microcephaly. Other defects seen with exposure to the Zika virus in utero include: calcium deposits in the brain, eye defect, hearing loss and impaired growth. We are still trying to understand the extent of the Zika virus infection on the growth and development of unborn babies and newborns, but so far what we do know is not good at all. So what can pregnant women do?

1. Avoid traveling to any area currently affected by the Zika virus if at all possible.
2. If you must travel, check the cdc.gov site for updated information on affected areas.
3. While traveling to affected areas, protect yourself from mosquito bites, i.e. wear long sleeves (preferably light colored clothes) and use appropriate mosquito repellant product, sleep under mosquito netting.
4. Stay indoors in places with air-conditioning and with window and door screens.
5. Do not have unprotected intercourse with your partner, if he or she has traveled to an area affected by the Zika virus, the evidence thus far shows that the Zika virus can remain alive in semen for up to 6 months, in women the virus can stay around for up to 8 weeks after initial infection. That rule also applies to sharing sex toys.
6. After your trip, continue wearing mosquito repellant and avoid mosquito bites for up to three weeks in case you have been infected so you won’t pass it to the mosquitoes who can then transmit it to another person.
7. Finally see your doctor as soon as possible. While there are no current treatment for the Zika virus, early detection through testing (blood & amniotic fluid) can be used to counsel pregnant women and their partners accordingly. Your doctor may or may not recommend an ultrasound to evaluate your baby and decide whether you need to see a high risk ob specialist.
8. Pregnant women in areas with a high prevalence of Zika infection should get tested in the first and second trimester.
9. Talk to your doctor and bring a list of questions with you whether you are pregnant and living an a Zika affected area or have traveled to one so you don’t forget the details of the conversation and take charge of your health.
10. Women infected with the Zika virus can continue to breastfeed. Thus far neither the WHO (World Health Organization, nor the CDC have any evidence of the Zika virus being transmitted to babies through breastmilk.

Ultimately it is important for women and their partner to delay pregnancy if they are living or planning to travel to an area affected by the Zika virus. Currently that is our most powerful tool against the birth defect caused by the Zika virus.

Tomorrow we tackle the Zika virus and how it is re-shaping reproductive health now that we know that is a sexually transmitted disease.