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Microcephaly associated with Zika virus

A. Sosa Olavarría, Carlos Brito M, Suhey Bustamante, José Luis Goncálvez.

Article Published: May 2, 2016

Sociedad Venezolana de Ultrasonografía en Obstetricia y Ginecología (SOVUOG). Valencia Venezuela

Case report

A19-year old woman living in Zika virus endemic area was sent yo our unit. The clinical examination revealed mild fever, conjunctivitis, hands and feet arthralgia, rash with itching lasting for 5 days. Viral Zika infection was diagnosed and occurred at 6 weeks. It is our second case, among 211 pregnant patients exposed to the virus, the diagnosis was made at 24 weeks 5 days.

Our ultrasonographic examinations shows the following findings:


Images 1, 2: 2D images of the fetal head show interorbital diameter greater than biparietal diameter. 

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Images 3, 4: 2D and 3D images revealed flat profile and prefrontal edema.
    
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Images 5, 6, 7, and 8:  2D and 3D images of the fetal head show a frontomaxillary angle of 60 degrees and head circumference z-score less than - 2.6, redundant scalp.

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Images 9, 10:  2D images showing thalamocortical distance 0,77 mm, occipitofrontal 5,14 mm diameter, frontal lobe 1.30. Brain calcifications were also observed.

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Images 11, 12: Color doppler images showing pericallosal artery surface near of the cerebral cortex and Willis circle in normal position. 

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Image 13: 2D image of the fetal head shows increased subarachnoid space. 

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Images 14, 15, 16 and 17:  2D and 3D images of the fetal arms, extended without movements suggesting fetal hypokinesia and hand in abnormal position.

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 Image 18:

Fetal phenotype confirming the ultrasound findings.

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