Hematological Profile of Pregnant Women with Suspected Zika Virus Infection Followed Up at a Referral Service in Manaus, Brazil.

The purpose of this paper is to describe the hematological profile of pregnant women with suspected Zika virus (ZIKV) infection followed up at a reference service for infectious diseases in Manaus, Brazil, through a clinical, epidemiological, cross-sectional study of pregnant women with an exanthematic manifestation who looked for care between 2015 and 2017. The participants were 499 pregnant women, classified into four subgroups, according to laboratory confirmation of infections: ZIKV-positive; ZIKV-positive and positive for another infection; positive for another infection but not ZIKV-positive; and not positive for any of the infections investigated. Hematological parameters were analyzed descriptively. The association between maternal infection and the hematological profile, along with the association between the maternal hematological profile and the gestational outcome, were tested. Similar hematic and platelet parameters were observed among pregnant women. However, a significant association was observed between low maternal lymphocyte count and a positive diagnosis for ZIKV (p < 0.001). The increase in maternal platelet count and the occurrence of unfavorable gestational outcome were positively associated. A similar hematic and platelet profile was identified among pregnant women, differing only in the low lymphocyte count among ZIKV-positive pregnant women. Regarding gestational outcomes, in addition to the damage caused by ZIKV infection, altered maternal platelets may lead to unfavorable outcomes, with the need for adequate follow-up during prenatal care.

Zika Virus Infection in a Cohort of Pregnant Women with Exanthematic Disease in Manaus, Brazilian Amazon.

The epidemic transmission of Zika virus (ZIKV) in Brazil has been identified as a cause of microcephaly and other neurological malformations in the babies of ZIKV-infected women. The frequency of adverse outcomes of Zika virus infection (ZIKVi) in pregnancy differs depending on the characteristics of exposure to infection, the time of recruitment of research participants, and the outcomes to be observed. This study provides a descriptive analysis-from the onset of symptoms to delivery-of a cohort registered as having maternal ZIKVi in pregnancy, from November 2015 to December 2016. Suspected cases were registered at a referral center for infectious and tropical diseases in Manaus, in the Amazonian region of Brazil. Of 834 women notified, 762 women with confirmed pregnancies were enrolled. Reverse-transcriptase polymerase chain reaction (RT-PCR) confirmed ZIKVi in 42.3% of the cohort. In 35.2% of the cohort, ZIKV was the sole infection identified. Severe adverse pregnancy outcomes (miscarriage, stillbirth, or microcephaly) were observed in both RT-PCR ZIKV-positive (5.0%) and ZIKV-negative (1.8%) cases (RR 3.1; 95% IC 1.4-7.3; p < 0.05), especially during the first trimester of pregnancy (RR 6.2, 95% IC 2.3-16.5; p < 0.001). Although other infectious rash diseases were observed in the pregnant women in the study, having confirmed maternal ZIKVi was the most important risk factor for serious adverse pregnancy events.

Zika Vírus: conhecimentos, sentimentos e rede de apoio social de gestantes / Zika Virus: conocimientos, sentimientos y red de apoyo social para embarazadas / Zika Virus: knowledge, feelings and social support network of pregnant women

Objetivo: compreender os conhecimentos, os sentimentos e a rede de apoio social de gestantes sob suspeita e diagnóstico positivo de Zika vírus. Método: estudo descritivo, com abordagem qualitativa, realizado com 10 gestantes. Os dados foram coletados no segundo semestre de 2017, por meio de entrevista semiestruturada e analisados pela técnica de análise temática. Resultados: evidenciou-se o déficit de conhecimento sobre a patologia na gestação e os sinais e sintomas apresentados. Sentimentos negativos como medo, desespero e choro estão associados as possibilidades de repercussão fetal frente à suspeita e diagnóstico de microcefalia do bebê. O cuidado multiprofissional, juntamente com a família e as crenças religiosas foram vistos como rede de apoio para o enfrentamento da doença. Considerações finais: o conhecimento, os sentimentos e a rede de apoio são essenciais para se pensar políticas e a própria organização dos serviços de saúde, na perspectiva do enfretamento e do cuidado em saúde.

Objective: to understand the knowledge, emotions and social support network of pregnant women with clinical suspicion or positive diagnosis of Zika virus. Method: a descriptive study with a qualitative approach, performed with ten pregnant women. Data were collected in the second semester of 2017, through semi-structured interviews and analyzed by thematic analysis technique. Results: the women demonstrated a lack of knowledge about the pathology and signs and symptoms during pregnancy. Feelings of fear, despair and tearfulness are associated with the possibility of fetal repercussions when faced with a diagnostic suspicion of microcephaly. Multiprofessional care, along with family and religious beliefs were seen to offer a support network for coping with the disease. Final considerations: knowledge, feelings and support networks are essential when considering the policies and organization of health services, from the perspective of coping and health care.

Objetivo: comprender los conocimientos, los sentimientos y la red de apoyo social para embarazadas bajo sospecha y diagnóstico positivo de Zika virus. Método: estudio descriptivo, con abordaje cualitativo, realizado con 10 mujeres embarazadas. Los datos fueron recolectados el segundo semestre de 2017, por medio de entrevista semi estructurada y analizados por la técnica de análisis temática. Resultados: se evidenció el déficit de conocimiento sobre la patología en el embarazo y los signos y síntomas. Sentimientos de miedo, desesperación y llanto están asociados a las posibilidades de repercusión fetal frente a la sospecha y diagnóstico de microcefalia del bebé. El cuidado multiprofesional, juntamente con la familia y las creencias religiosas fueron vistos como red de apoyo para el enfrentamiento de la enfermedad. Consideraciones finales: el conocimiento, los sentimientos y la red de apoyo son esenciales para pensar políticas y la propia organización de los servicios de salud, en la perspectiva del enfrentamiento y del cuidado en salud.