From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damage to the central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection's devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR) with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKV urine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised. ResumoDesde a descoberta do vírus Zika (VZIK) em 1947 em Uganda, na África, até sua chegada na América do Sul, não se tinha notícia de que ele seria capaz de comprometer a vida reprodutiva em humanos de forma tão severa. Hoje, sabe-se que os danos sobre o sistema nervoso central são múltiplos, e a microcefalia é considerada a ponta do iceberg, visto que na realidade ela representa o epílogo de um processo devastador desta infecção sobre o sistema nervoso central do embrião e do feto. Em decorrência da agressão do sistema nervoso central pelo VZIK, est...

A brief report on the nature and epidemiology of T. gondii infection is firstly presented. The importance of the specific IgG avidity test and polymerase chain reaction (PCR) for toxoplasmosis is discussed, along with their significance and importance as auxiliary methods for determining the most likely time for the initial infection by this coccidian and for defining the therapeutic strategy. Lastly, practical comments are made in relation to the classical therapeutic regimens, with special attention to the indications for fetal treatment, when this is necessary.

The embryo volume (EV) is an important parameter for the early diagnosis of growth disorders. The objective of this study was to establish normal data for EV at 7-10 weeks' gestation with three-dimensional ultrasonography (3DUS). A cross-sectional study involving 50 pregnancies was performed. An endocavitary volumetric transducer (3D5-8EK) was used for all measurements. The VOCAL (Virtual Organ Computer-aided AnaLysis) method with a 30 degrees rotation angle was used for volumetric calculations. To analyse the correlation between EV and gestational age (GA) and crown-rump length (CRL), regression models were constructed. The mean, standard deviation, median, minimum and maximum values were calculated for each gestational age. The intraclass correlation coefficient (ICC) was used to determine inter- and intraobserver reliability. There was a significant correlation between EV and GA and CRL (R(2) = 0.951 and R(2) = 0.880, respectively). The exponential equation was the model that best expressed the correlation between these variables: [EV = exp(0.9481 x GA-8.117)] and [EV = 0.0871 exp(0.1207 x CRL)]. The mean EV ranged from 0.23 cm(3) (95% CI 0.03-0.42) at 7 weeks to 3.91 cm(3) (95% CI 3.85-3.96) at 10 weeks. Inter- and intraobserver correlation were excellent (ICC = 0.993 and 0.999, respectively). Embryo volume assessed through 3DUS increased from 7 to 10 weeks. Reference limits were generated for first trimester EV using 3DUS.

We sought to establish normative data for three-dimensional ultrasound (3DUS) first-trimester embryonic volume using the extended imaging virtual organ computer-aided analysis (XI VOCAL) technique. This cross-sectional study involved 64 normal pregnancies at 7 to 10 + 6 weeks' gestation. Embryonic volume was obtained on 3DUS using the XI VOCAL technique with manual outline of 10 sequential planes. The mean, median, standard deviation, and maximum and minimum values were obtained for each week calculated. Polynomial regression models adjusted by the determination coefficient (R(2)) were created to assess the correlation between embryonic volume and gestational age (GA) and crown rump length (CRL). The intraclass correlation coefficient (ICC) was used to calculate inter- and intraobserver reproducibility. Mean embryonic volume went from 0.20 cm(3) (range 0.10 to 0.89 cm(3)) to 5.12 cm(3) (range 2.90 to 5.98 cm(3)). Embryonic volume was strongly correlated with GA (R(2) = 0.84) and with CRL (R(2) = 0.87). There was a good inter- and intraobserver reproducibility of embryonic volume with ICC = 0.999 and 0.995, respectively. Reference range for 3DUS first-trimester embryonic volume using the XI VOCAL technique were generated for pregnancies at 7 to 10 + 6 weeks, with high inter- and intraobserver reproducibility.

The three 3D ultrasound methods used for GSV assessment between 7 and 11 weeks are concordant. These methods can be used interchangeably during the first trimester of pregnancy to measure GSV.