Rhonda Reeves: Zika virus and pregnancy
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.
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.
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.
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 anti-inflammatory 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:
• 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.
n 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 their 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.
- Dr Rhonda Reeves is the Obstetrician/Gynaecologist at Southdale Medical & Gynae Centre, Shop 6, Southdale Plaza. Email: firstname.lastname@example.org.