Pregnant Women Considering Travel to an Area of Zika Virus Transmission:

  • All pregnant women should consider postponing travels to areas where Zika virus transmission is ongoing.
  • If a pregnant woman travels to an area with Zika virus transmission, she should be advised to follow steps to avoid mosquito bites (eg, wearing long-sleeved shirts and long pants, using U.S. EPA-registered insect repellents, using permethrin-treated clothing and gear, staying and sleeping in screened-in or air-conditioned rooms)

Pregnant Women With a History of Travel to an Area of Zika Virus Transmission:

  • All pregnant women should be asked about recent travel.
  • Because of similar clinical presentation, patients with symptoms consistent with Zika virus should also be evaluated for dengue and chikungunya virus infection. 
  • Reverse transcription-polymerase chain reaction (RT-PCR) testing of maternal serum should be done for symptomatic patients with onset of symptoms within the previous week. It may also be performed on amniotic fluid.
  • IgM and neutralizing antibody testing should be performed on specimens collected at least 4 days after symptom onset. 
  • Testing of asymptomatic pregnant women is not recommended in the absence of fetal microcephaly or intracranial calcifications.
  • For a live birth with evidence of maternal or fetal Zika virus infection, the following tests are recommended: histopathologic examination of the placenta and umbilical cord, testing of frozen placental tissue and cord tissue for Zika virus RNA, and testing of cord serum for Zika and dengue virus IgM and neutralizing antibodies.

Pregnant Women with Diagnoses of Zika Virus Disease:

  • No specific antiviral treatment is available. 
  • Supportive care can include rest, fluids, analgesics, and antipyretics. 
  • Although typically not used in pregnancy, aspirin and other NSAIDs should be specifically avoided until dengue can be ruled out to reduce the risk for hemorrhage.
  • If laboratory evidence of Zika virus is seen in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every 3-4 weeks.
  • Referral to a maternal-fetal medicine or infectious disease specialist is recommended.

A list of updates on areas with ongoing Zika virus transmission can be found here. The CDC stated that further investigation is required to determine the full range of outcomes that might be associated with Zika virus infections during pregnancy. 

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