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S
imões
R
et
al
.
106
R
ev
A
ssoc
M
ed
B
ras
2016; 62(2):106-107
B
ernardo
WM
U
pdate
on
Z
ika
virus
infection
in
pregnancy
F
elipe
-S
ilva
A
ACCREDITATION
Update on Zika virus infection in pregnancy
A
tualização
em
infecção
pelo
vírus
Z
ika
na
gravidez
R
icardo
S
imões
1,2
, R
enata
B
uzzini
²
, W
anderley
B
ernardo
2
, F
lorentino
C
ardoso
²
, A
ntônio
S
alomão
1
, G
iovanni
C
erri
²
1
Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo)
2
Guidelines Project, AMB
http://dx.doi.org/10.1590/1806-9282.62.02.1061. Which factors may be related to the substantial
increase in the number of cases of microcephaly
in Brazil?
a.
Increased active search for this congenital malfor-
mation.
b.
Increase in the number of pregnant women traveling
to northeastern Brazil.
c.
Change in diagnostic criteria.
d.
Alternatives a and c are correct.
2. What is the clinical and laboratory method indicat-
ed (sensitivity and specificity) to confirmZika virus
infection within a week of the onset of symptoms?
a.
Immunoenzymatic assay (ELISA).
b.
Plaque-reduction neutralization test (PRNT).
c.
Reverse transcriptase technique.
d.
Real-time polymerase chain reaction (RT-PCR).
e.
Indirect immunofluorescence.
3. Regarding symptoms in pregnant women with
suspected Zika virus infection, we know that:
a.
Most are asymptomatic.
b.
Patients can manifest fever, rash and fatigue.
c.
Patients may present with purulent conjunctivitis,
generalized joint pain, vomiting.
d.
Alternatives a and b are correct.
4. What treatments are recommended for people in-
fected with Zika virus?
a.
Flu vaccine.
b.
Analgesic agents, rest and antibiotics.
c.
Hydration, rest and non-salicylic analgesic drugs.
d.
Saline solution, anti-inflammatory drugs, good nu-
trition.
5. Regarding pregnant women diagnosed with Zika
virus infection, we know that:
a.
Care must be maintained according to conventional
prenatal protocol if there are no symptoms, and wait
until birth for other assessments.
b.
Fetal ultrasounds must be done in series every 3 to
4 weeks, and the newborn should receive complete
physical examination with ophthalmologic assess-
ment.
c.
The patient should be referred for high-risk care at a
prenatal service with specialized doctors, and the new-
born should be evaluated by measuring the head cir-
cumference.
d.
Evaluation should be done with frequent ultrasounds
and, after birth, the newborn should have a head cir-
cumference of less than 34 cm to configure a need
for more specific analyses.
A
nswers
to
clinical
scenario
: U
pdate
on
cesarean
delivery
and
small
newborn
for
gestational
age
[
published
in
RAMB 2016;
62(1)]
1. What is themost important single factor inneonatal
mortality, in addition to being a significant determi-
nant of postnatal mortality and infant morbidity?
Birth weight. (Alternative
D
)
2. A retrospective study considered in this analysis sug-
gested that SGA newborns exposed to labor have in-
creased risk of early neonatal death compared with
those not subject to labor. But in the same study, a
lower risk of death was identified for what periods?
For the late neonatal and postnatal periods in those
born vaginally, regardless of gestational age. (Alter-
native
A
)
3. A retrospective study by Lee HC et al. showed in-
consistent results; what was found?
SGA newborns with 31 weeks presented a decrease
in late neonatal mortality at the time of cesarian sec-
tion, while SGA newborns with a gestational age > 33
weeks, as well as those regarded as AGA (appropriate
for gestational age), showed an increase in mortality
in cases of cesarian section. (Alternative
B
)