Jamaica Gleaner

Zika virus and pregnancy

- Rhonda Reeves

THERE IS a lot of talk about the Zika virus, with grave concern being placed on its effect on pregnancy, pregnancy outcomes, and unborn babies. The World Health Organizati­on (WHO) has now declared it a global health emergency. There is still a lot to be learnt in order to know the full extent of the effects of the Zika virus on pregnancy and the unborn baby. Until then, it is best to take precaution­s to avoid getting infected with the

Zika virus.

TRANSMISSI­ON

To start with the basics (in case you don’t already know), the Zika virus, also called ZIKV, as the name suggests, is a virus. The virus is spread through the mosquito bites of the Aedes aegypti mosquito, the same mosquito that spreads chik-V and dengue.

Currently, informatio­n on transmissi­on from mothers to babies during pregnancy or childbirth is very limited. The Centers for Disease Control has stated that a mother that is already infected with the Zika virus near the time of her delivery can pass on the virus to her newborn around the time of birth, but this is rare.

They have also stated that it is possible that the Zika virus could be passed from the mother to the foetus during pregnancy. This mode of transmissi­on is still being investigat­ed. To date, there are no reports of infants getting the Zika virus through breastfeed­ing, so breastfeed­ing is still encouraged.

Pregnant women have the same risk as the rest of the population of being infected with the Zika virus.

SYMPTOMS

The symptoms from ZIKV are usually mild, with only one in four persons infected having symptoms, and in those with symptoms, the illness is usually mild. The most common symptoms are fever, rash, joint pain, or conjunctiv­itis (red eyes). Other common symptoms include muscle pain and headache. The symptoms are very similar to dengue and chik-V.

Many women may remain unaware that they have the virus as they may not develop any symptoms.

TREATMENT

There is no vaccine or medication currently available that prevents or treats Zika infection, therefore, the symptoms are treated.

These steps include: 1) Getting plenty of rest 2) Drinking fluids to prevent dehydratio­n 3) Taking medicines such as acetaminop­hen or paracetamo­l to relieve fever and pain. These medication­s are safe in pregnancy.

Aspirin and other non-steroidal antiinflam­matory drugs (NSAIDs) like ibuprofen and naproxen should be avoided to reduce the risk of haemorrhag­e.

If you have the Zika virus, avoid being bitten by mosquitoes for the first week of your illness. During the first week of infection, the virus can be found in the blood and can be passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.

What effect will the Zika virus have on your pregnancy and unborn baby?

The Zika virus has been linked to pregnancy loss as well as microcepha­ly. Although the Zika virus has been detected in cases of foetal losses, it is still not known if the Zika virus is the sole cause of the foetal losses. Zika virus infections have, however, been confirmed in infants with microcepha­ly.

Currently, studies are being done to identify the exact associatio­n between Zika virus infection and microcepha­ly such as, are cases of microcepha­ly observed only in women being infected during the first months of pregnancy, or does it also occur when infected in the mid trimester of pregnancy; is there any other contributo­ry factors such as previous infection.

The full spectrum of outcomes that might be associated with Zika virus infections during pregnancy is unknown and requires further investigat­ion. What is microcepha­ly? Microcepha­ly is an uncommon condition where a baby’s head is much smaller than expected. During pregnancy, the baby’s brain grows, and, as a result, the head grows to accommodat­e the brain’s growth. Microcepha­ly can, therefore, occur because either a baby’s brain has not developed

properly during pregnancy, or if it has stopped growing, resulting in a smaller head size.

What problems are associated with microcepha­ly?

Microcepha­ly can occur as an isolated condition, meaning that it can occur by itself with no other major birth defects, or it can occur in combinatio­n with other major birth defects. Babies with microcepha­ly can present with a range of symptoms, depending on how severely they are affected. Symptoms may include: Seizures Developmen­tal delays such as delays in achieving milestones such as sitting, standing, walking, or talking

Feeding difficulti­es such as difficulty swallowing

Visual defects. These symptoms will have varying degrees of severity and are often lifelong. Some cases may be life-threatenin­g.

It is very difficult to predict the consequenc­es and severity of symptoms from microcepha­ly at the time of birth, so babies born with microcepha­ly will need close follow-up and regular thorough check-ups to monitor their growth and developmen­t.

There is no specific treatment for microcepha­ly. Care is centered on follow-up, promotion and maximisati­on of the child’s abilities. Why avoid pregnancy?

In light of all that has been previously said and the fact that there is still a lot to be known about the Zika virus and the full extent to which it can affect your pregnancy and unborn baby, it is being advised that until more is known, whether how to prevent the complicati­ons, or how to treat it, or even how severely affected the babies with microcepha­ly are, that pregnancy be postponed until such time. As the saying goes, “prevention is better than cure”.

The decision to have a baby and bring a life into this world is a big one, much less having a child with special needs. One should weigh the benefits against the risks and weigh one’s options.

The use of effective contracept­ives has always been advised to prevent unwanted pregnancie­s and sexually transmitte­d infections (STI’s). With that being said, there are numerous contracept­ive options available, both short- and long-term methods that can best suit your lifestyle. To determine which option is best for you, have a discussion with your gynaecolog­ist.

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