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Guidance During a Zika Virus Outbreak

ACOG’s advisory for care of obstetric patients

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) have issued a practice advisory on interim guidance for care of obstetric patients during a Zika virus outbreak. The practice advisory reiterates prevention strategies to minimize exposure to Zika and summarizes the current guidance for management of pregnant women who have been exposed.

The virus spreads to humans primarily through infected Aedes aegyti mosquitoes. Zika during pregnancy has been associated with birth defects, specifically significant microcephaly. It was reported in May 2015 in South America and since then has spread throughout the Americas. Currently there is no vaccine or treatment for this infection. The ACOG practice advisory includes the following prevention guidance:

• Avoiding exposure is best. Pregnant women should delay travel to areas where Zika outbreaks are ongoing when possible. Women considering pregnancy should discuss the advisability of travel with their obstetric providers.

• When traveling to areas where Zika has been reported, take all precautions to avoid mosquito bites including the use of EPA-approved bug spray with DEET, covering exposed skin, staying in air-conditioned or screened-in areas, and treating clothing with permethrin.

• Providers should specifically communicate to pregnant women that when used as directed on the product label, EPA-registered insect repellents including those with DEET and permethrin can be used safely during pregnancy.

• These protective measures should be followed both day and night as the Aedes aegyti mosquito (which carries Zika virus) bites primarily during the day as well as at dusk and dawn. Reapplication of insect repellant should be practiced as directed on the product label.

Citation: The American College of Obstetricians and Gynecologists. Practice advisory: interim guidance for care of obstetric patients during a Zika virus outbreak. ACOG Web site. Accessed January 26, 2016.