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Lancet Infect Dis. 2017 May;17(5):520-527. doi: 10.1016/S1473-3099(17)30102-0. Epub 2017 Feb 11.

Analysis of blood from Zika virus-infected fetuses: a prospective case series.

Author information

1
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.
2
Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University Hospital, Lausanne, Switzerland; Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland.
3
Service de Virologie, Hôpital de la Meynard, Centre Hospitalier Universitaire de Martinique, Fort de France, France.
4
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.
5
Service de Gynécologie Obstétrique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort de France, France.
6
Laboratoire de Biochimie, Hôpital Robert-Debré, Paris, France.
7
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 Radiologie, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort de France, France.
8
Centre National de Référence des Arboviroses, Institut de Recherche Biomédicale des Armées, Marseille, France.
9
Service de Virologie, Hôpital de la Meynard, Centre Hospitalier Universitaire de Martinique, Fort de France, France; University Antilles, Fort-de-France, France.
10
Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University Hospital, Lausanne, Switzerland; Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland. Electronic address: david.baud@chuv.ch.

Erratum in

Abstract

BACKGROUND:

Zika 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.

METHODS:

Since 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.

FINDINGS:

Between 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.

INTERPRETATION:

Normalisation 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.

FUNDING:

None.

PMID:
28209336
DOI:
10.1016/S1473-3099(17)30102-0
[Indexed for MEDLINE]

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