How pregnant pregnant women need Zika to handle

Pregnancy if ultrasound shows signs of a small head or abnormal brain, it is necessary to go to a medical facility capable of prenatal diagnosis to monitor and consider amniocentesis screening for birth defects.

Guidelines for the diagnosis and treatment of Zika virus disease issued by the Ministry of Health, determine the criteria for diagnosing a suspected case of Zika infection including:

1. There are at least 2 of the clinical symptoms such as mild fever 37.5 to 38 degrees C, skin rash, headache, arthralgia, ocular conjunctivitis. There may be neurological complications: Guillain Barre, meningoencephalitis or baby brain syndrome in babies born to mothers who are infected during pregnancy. Ultrasound will help detect if the fetus has a smaller brain than usual.
2. Epidemiological factors: People who have lived or traveled to the region where Zika virus has been circulated within 2 weeks before the onset of illness.
3. In the case of the above symptoms, but not identified other causes of disease such as dengue, Chikungunya . are also suspected of being infected with Zika.
4. Women who have all of the following factors should be tested for Zika: Pregnancy in the first 3 months, living or once in the affected area, husband or partner who has tested Zika positive, fever or outbreak rash and at least one of the symptoms of joint muscle aches, conjunctivitis.

In order to diagnose a confirmed case from these suspected cases, it is necessary to have a Zika positive RT-PCR test or a positive serum (IgM) response to Zika virus.

Pregnant women who have been tested for Zika virus infection, can treat symptoms if needed.(Artwork: Newsweek).

The Ministry of Health recommends that all pregnant women be examined and monitored by pregnancy. Check at least 4 times throughout your pregnancy.

The first time as soon as possible in the first 3 months. The second time in the middle 3 months. Twice later in the last 3 months. In the context of complicated Zika epidemic, doctors need to ask their travel history to promptly detect whether their pregnant or husband / partner has ever been in the epidemic. Notice the signs and symptoms of disease. Differential diagnosis with syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes is also a cause of intrauterine infection and birth defects. Ultrasound to accurately assess fetal age and fetal morphology to detect small head.

Pregnant women who have been tested for Zika virus infection, can treat symptoms if needed. Ultrasound results show no signs of suspected small head or abnormal brain development, so follow-up care and pregnancy care should continue. Periodic ultrasound monitoring is required.

If the mother is negative for Zika, but the results of the ultrasound suspect that the baby has a small head or brain abnormality, it is necessary to transfer to the facility with prenatal diagnosis to confirm the small head. Consider conducting amniocentesis or other tests to screen for birth defects. If the diagnosis determines that the fetus has a small head, additional tests are needed to support the diagnosis of the cause and other malformations. Medical doctors need to provide adequate information and advice to pregnant women and family members. If the family decides to keep pregnant, it is necessary to continue care, counseling and psychological support before birth as well as preparing a baby care plan.

For pregnant women who have been tested for Zika positive virus results, maternity care should be based on ultrasound results for proper management. If the ultrasound does not show signs of small or abnormal brain head, continue to monitor, take care of prescribed pregnancy, repeat ultrasound appointment every month. In case of signs of small or abnormal brain head, it is necessary to transfer to a facility with prenatal diagnosis for diagnosis of small head. Consider conducting amniocentesis or other tests to screen for birth defects. If a small head is identified, make other probes to find out the cause.

In case the family still wants to keep the pregnancy, should continue to provide care, counseling and psychological support before and after birth and prepare a newborn care plan. If the Zika test is positive, this is a case of a link between Zika virus and small head or brain abnormalities.

Pregnant women have not tested Zika, if the ultrasound does not show that the fetus has signs of small or abnormal brain head, continue to monitor, care and ultrasound again. In case of signs of suspected small head or abnormal brain, pregnant women need to do Zika test and transfer to the facility capable of prenatal diagnosis for diagnosis. If the fetus is identified as having a small head, additional investigations must be conducted to diagnose the cause and detect other defects.

Note: Zika positive test result is a case of suspicion of association between Zika virus and small head or brain abnormalities.