Intrauterine Zika virus infection and microcephaly: correlation of perinatal imaging and three-dimensional virtual physical models

Werner, Heron; Fazecas, Tatiana; Guedes, Bianca; Santos, Jorge Lopes Dos; Daltro, Pedro; Tonni, Gabriele; Campbell, Stuart; Júnior, Edward Araujo

doi:10.1002/uog.15901

Cited by 52 publications

(40 citation statements)

References 22 publications

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“…In these cases, the mothers had symptoms related to Zika virus infection, and positive polymerase chain reaction for Zika virus was found in the amniotic fluid in two cases [5], and retrospective assessment of maternal Zika virus infection was found in the third case [6]. All three fetuses showed microcephaly and parenchymal calcifications.…”

Section: Discussionmentioning

confidence: 99%

“…However, occipital pseudocysts and cortical anomalies were not described in two Brazilian cases [5]. Analysis of the MR sagittal image provided in the third Brazilian case [6] reveals the presence of an occipital pseudocyst. In our study, there is no doubt that MRI helped in detecting polymicrogyria, laminar necrosis and brainstem anomalies.…”

Section: Discussionmentioning

confidence: 99%

“…There is also concern for potential sexual transmission [9]. The possibility of maternofetal transmission was first suggested in two Polynesian newborns [10], and vertical transmission to the fetus has been recently documented in Brazil [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…The link between maternal Zika virus infection and fetal microcephaly has recently been proved in the French Polynesian population [4]. Prenatal US findings have been reported recently in two cases in Brazil [5]; in a third Brazilian case, the mother underwent US and MRI [6]. The purpose of this study was to describe and analyze the MRI findings observed in the brain of fetuses diagnosed with Zika virus infection.…”

Section: Introductionmentioning

confidence: 95%

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Prenatal brain MRI of fetuses with Zika virus infection

et al. 2016

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Results Three out of 12 cases of severe cerebral lesions fulfilled all inclusion criteria. History of maternal Zika virus infection had been documented in two cases. Calcifications and ventriculomegaly were present at US in all cases. MRI showed micrencephaly (n = 3), low cerebellar biometry (n = 2), occipital subependymal pseudocysts (n = 2), polymicrogyria with laminar necrosis and opercular dysplasia (n = 3), absent (n = 1) or hypoplastic (n = 1) corpus callosum and hypoplastic brainstem (n = 1). Conclusion Severe cerebral damage was observed in our series, with indirect findings suggesting that the germinal matrix is the principal target for Zika virus. The lesions are very similar to severe forms of congenital cytomegalovirus and lymphocytic choriomeningitis virus infections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Prenatal brain MRI of fetuses with Zika virus infection

et al. 2016

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“…Microcephaly can be defined as BPD and HC > 3 standard deviations (SD) below the mean for gestational age using Brazilian based reference ranges [4]. Small for gestational age (SGA) and large for gestational age (LGA) have been used to define abnormal fetal growth.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Dias

Chandrasiri

Abeykoon³

et al. 2017

Ceylon Med. J.

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Objectives The aim of this study was to compare fetal biometry of singleton fetuses in pregnant women with normal nutritional and health status in the Ampara district, with a commonly used reference chart.Methods A cross sectional study was carried out in the Ampara District. Women with normal nutritional and health status and minimal environmental constraints on fetal growth (n=714) were enrolled during the first trimester and gestational age was confirmed by fetal crown-rump length measurement between 11 weeks + 0 days and 13 weeks + 6 days. For this study, each mother was considered only once for measurement of fetal biometry, at gestations between 11 and 41 weeks. Fetal bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were measured using standard techniques, and separate regression models were fitted to estimate the means and standard deviations and derive gestation specific centiles for each parameter, assuming that the measurements have a normal distribution at each gestational age. The fetal biometry results obtained from the current study were compared with a commonly used reference chart. ResultsThe fitted 10th, 50th and 90th centiles at 40 weeks of gestation were, 87.9 mm, 93.2 mm and 98.5 mm for BPD, 313.8 mm, 328.9 mm and 344.0 mm for HC; 298.2 mm, 322.5 mm and 346.9 mm for AC and 69.7 mm, 75.0 mm and 80.2 mm for FL. When compared with the reference chart, significant differences of fetal biometry were seen in the third trimester but not in the second trimester.Conclusions Ultrasound fetal biometry of singleton fetuses in pregnant women with normal nutritional and health status in the Ampara District were significantly different in the third trimester, from a routinely used reference chart.Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

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Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians

et al. 2017

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ontracted through the bite of an infected mosquito or through sexual or other modes of transmission, Zika virus (ZIKV) infection can be prenatally passed from mother to fetus. 1 The virus was first identified in the region of the Americas in early 2015, when local transmission was reported in Brazil. 2 Six months later, a notable increase in the number of infants with congenital microcephaly was observed in northeast Brazil. 3,4 Clinical, epidemiologic, and laboratory evidence led investigators to conclude that intrauterine ZIKV infection was a cause of microcephaly and serious brain anomalies. [5][6][7] However, as with other newly recognized teratogens, these features likely represent a portion of a broader spectrum.A comprehensive review of the English literature, identified by searching Medline and EMBASE for Zika from inception through Sep-tember 30, 2016, was done to better characterize the spectrum of anomalies in fetuses and infants with presumed or laboratoryconfirmed ZIKV infection. A constellation of anomalies that is both consistent and unique, called congenital Zika syndrome (CZS), has emerged but specific components and presumed pathogenetic mechanisms previously have not been well-delineated. [8][9][10] Zika virus infection has spread to more than 45 countries in the Americas and 3 US territories, and, most recently, local transmission was confirmed in the continental United States in the state of Florida. 11 Mosquito-borne transmission of ZIKV in other areas of the United States is possible based on the estimated range of its vectors (Aedes aegypti and Aedes albopictus). 12 Recognition of the CZS phenotype by pediatric clinicians will help ensure appropriate and timely evaluation and follow-up of affected infants.IMPORTANCE Zika virus infection can be prenatally passed from a pregnant woman to her fetus. There is sufficient evidence to conclude that intrauterine Zika virus infection is a cause of microcephaly and serious brain anomalies, but the full spectrum of anomalies has not been delineated. To inform pediatric clinicians who may be called on to evaluate and treat affected infants and children, we review the most recent evidence to better characterize congenital Zika syndrome.OBSERVATIONS We reviewed published reports of congenital anomalies occurring in fetuses or infants with presumed or laboratory-confirmed intrauterine Zika virus infection. We conducted a comprehensive search of the English literature using Medline and EMBASE for Zika from inception through September 30, 2016. Congenital anomalies were considered in the context of the presumed pathogenetic mechanism related to the neurotropic properties of the virus. We conclude that congenital Zika syndrome is a recognizable pattern of structural anomalies and functional disabilities secondary to central and, perhaps, peripheral nervous system damage. Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital infections, there are 5 features that are rarely seen w...

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Intrauterine Zika virus infection and microcephaly: correlation of perinatal imaging and three-dimensional virtual physical models

Cited by 52 publications

References 22 publications

Prenatal brain MRI of fetuses with Zika virus infection

Prenatal brain MRI of fetuses with Zika virus infection

Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians

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