• Bruno Schaub, Manon Vouga, Fatiha Najioullah, Michèle Gueneret, Alice Monthieux, Caroline Harte, Françoise Muller, Eugénie Jolivet, Clara Adenet, Sophie Dreux, Isabelle Leparc-Goffart, Raymond Cesaire, Jean-Luc Volumenie, and David Baud.
• Centre Pluridisciplinaire de Diagnostic Prénatal de Martinique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort de France, France; Service de Gynécologie Obstétrique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort de France, France; Registre des Malformations des Antilles, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort de France, France.
• Lancet Infect Dis. 2017 May 1; 17 (5): 520-527.

BackgroundZika virus has spread through the Americas and the Caribbean since early 2015 and was rapidly declared a Public Health Emergency of International Concern by WHO because of the potential association with fetal anomalies. We analysed fetal and maternal fluids and tissues in fetuses with confirmed Zika virus infection prospectively monitored in Martinique, a French Caribbean island.MethodsSince the beginning of the Zika virus outbreak in Martinique, all pregnant women undergo monthly fetal ultrasound examination surveillance. In this study, we prospectively studied all patients with fetal anomalies and a positive amniotic fluid for Zika virus by RT-PCR. Maternal and fetal blood, urine, amniotic fluid, placenta, and fetal tissues were tested for Zika virus by RT-PCR. Fetal blood was analysed to identify haematological and biological anomalies.FindingsBetween Jan 1, 2016, and Nov 10, 2016, we recruited eight cases of Zika virus infection. All but two cases were symptomatic during the first trimester. Fetal anomalies were only detected after 20 weeks' gestation. After an initial positive result, amniocentesis became negative in two cases and fetal blood was transiently Zika virus-positive in six cases. Fetal blood analyses showed a cholestatic pattern, anaemia, and infectious response.InterpretationNormalisation of amniotic fluid and fetal blood for Zika virus, as well as maternal blood and urine, shows the limitations of the performance of these investigations, due to the possibility of false negative results. Abnormal fetal blood needs to be investigated further to establish prognostic factors of severe Zika virus infections.FundingNone.Copyright © 2017 Elsevier Ltd. All rights reserved.

34 keywords...

hide…