Congenital microcephaly is not an optimal screening method for congenital Zika virus (ZIKV) syndrome, as it may not accompany other evident and preceding brain findings, a recent study found. The longitudinal cohort of ZIKV-infected pregnancies focused on clinical and imaging findings of patients with laboratory-confirmed ZIKV infection and fetal brain anomalies. Patients underwent monthly fetal ultrasound scans, neurosonography, and a fetal MRI. Researchers found:

• All 214 subjects had been referred for ZIKV symptoms during pregnancy affecting themselves or their partners or if fetal anomalies compatible with congenital ZIKV syndrome were detected.
• 12 pregnant patients with laboratory confirmation of ZIKV infection were diagnosed with fetal brain malformations.
• The most common findings assessed by prenatal and postnatal imaging were: brain volume loss (92%), calcifications (92%), callosal anomalies (100%), cortical malformations (89%), and ventriculomegaly (92%).
• Microcephaly was present in 33.3 to 58.3% of the cases at referral and present at delivery in 55.6 to 77.8% of cases.