The Centers for Disease Control and Prevention (CDC) has issued interim updated guidance for health care providers caring for pregnant women with possible Zika virus exposure. Under the new guidelines, routine testing is no longer recommended for pregnant women without any Zika symptoms but who may have been put at risk because they live in a region with ongoing exposure or have traveled to a region where Zika is circulating. The updated recommendations reflect the ongoing trend that as the prevalence of Zika virus disease declines, the likelihood of false-positive test results increases. Among the key recommendations:
- All pregnant women in the US and US territories should be asked about possible Zika virus exposure before and during the current pregnancy, at every prenatal care visit.
- Pregnant women with recent possible Zika virus exposure and symptoms of Zika virus disease should be tested to diagnose the cause of their symptoms. The updated recommendations include concurrent Zika virus nucleic acid test (NAT) and serologic testing as soon as possible through 12 weeks after symptom onset.
- Asymptomatic pregnant women with ongoing possible Zika virus exposure should be offered Zika virus NAT testing 3 times during pregnancy. IgM testing is no longer routinely recommended.
- Asymptomatic pregnant women who have recent possible Zika virus exposure but without ongoing possible exposure are not routinely recommended to have Zika virus testing.
- Pregnant women who have recent possible Zika virus exposure and who have a fetus with prenatal ultrasound findings consistent with congenital Zika virus syndrome should receive Zika virus testing to assist in establishing the etiology of the birth defects.
- Zika virus IgM testing as part of preconception counseling to establish baseline IgM results for nonpregnant women with ongoing possible Zika virus exposure is not warranted.
Oduyebo T, Polen KD, Walke HT, et al. Update: Interim guidance for health care providers caring for pregnant women with possible Zika virus exposure—United States (including US territories), July 2017. [Published online ahead of print July 24, 2017]. MMWR Morb Mortal Wkly Rep. doi:10.15585/mmwr.mm6629e1.
This Week's Must Reads
ACOG: Well-Women Visits Can Minimize Health Risks, Obstet Gynecol; 2018 Oct; ACOG, et al
Gender Images & Social Expectations in BC Diagnosis, Cancer; ePub 2018 Sep 24; Kim, Glassgow, et al
Intended Pregnancy After Being Denied an Abortion, Contraception; ePub 2018 Sep 20; Upadhyay, et al
Opioid Prescribing After Surgery for Pelvic Organ Prolapse, Female Pelvic Med Reconstr Surg; ePub 2018 Sep 22; Leach, et al
VTE risk for continuous cycle oral contraceptives, Li J et al. JAMA Intern Med. 2018 Oct 1. doi:10.1001/jamainternmed.2018.4251
Must Reads in Clinical Guidelines
Prophylactic Antibiotic Use in Labor & Delivery, Obstet Gynecol; 2018 Sep; Coleman, et al
USPSTF on Screening for Cervical Cancer, JAMA; 2018 Aug 21; US Preventive Services Task Force
Prevention of Obstetric Lacerations at Vaginal Delivery, Obstet Gynecol; 2018 Sep; Cichowski, et al
Gynecologic Issues in Adolescents with Cancer, Obstet Gynecol; ePub 2018 Aug; ACOG, et al
Low-Dose Aspirin Use During Pregnancy, Obstet Gynecol; ePub 2018 Jul; ACOG, SMFM