The American College of Obstetricians and Gynecologists (ACOG) — the largest organization representing obstetricians and gynecologists in the United States — said Thursday that it supports new guidelines aimed at shielding pregnant women from the mosquito-borne Zika virus.
The virus — now present in many countries and regions in Central and South America and the Caribbean — can cause a serious birth defect, according to the U.S. Centers for Disease Control and Prevention.
Thousands of babies in Brazil were born last year with microcephaly, a brain disorder that experts associate with Zika exposure. Babies with the condition have abnormally small heads, resulting in developmental issues and, in some cases, death.
The CDC also said that cases of the neurological disorder Guillain-Barre syndrome have been reported in patients with probable Zika virus infection in Brazil and French Polynesia, although more study is needed to confirm the link.
According to a statement released late Thursday, ACOG is urging pregnant women and those planning a pregnancy to follow Zika virus travel and health guidelines recently issued by the CDC.
“Travel to regions with ongoing Zika virus outbreaks is not recommended for women who are pregnant or women who are considering pregnancy,” ACOG President Dr. Mark DeFrancesco said in the statement.
One week ago, the CDC issued a travel warning for pregnant women or women planning to get pregnant for the following countries and territories: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and Puerto Rico.
On Friday, the CDC added eight new countries to that list: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde, and Samoa.
The CDC says doctors should ask all pregnant patients about recent travel and specific symptoms, such as a sudden fever or rash. If Zika virus infection is possible, doctors should have the patient tested for the virus.
If tests reveal signs of infection, ultrasounds should be considered to monitor the fetus’ development, and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is also recommended, the CDC advised.
According to ACOG’s DeFrancesco, “there is much that we do not yet know about the Zika virus and its effects during pregnancy, for example whether pregnant women are of greater risk of infection than non-pregnant individuals. However, because of the associated risk of microcephaly, avoiding exposure to the virus is best. That’s why pregnant women and women who are considering pregnancy should delay planned travel to areas where Zika virus outbreaks are ongoing.”
Moreover, he added, “women traveling to areas where Zika virus has been reported should take all precautions to avoid mosquito bites, including covering exposed skin, staying in indoor- or screened-in areas, and using EPA-approved bug spray with DEET (which is safe for use during pregnancy),” DeFrancesco said.
“Because some women may have traveled to affected areas prior to this advisory, obstetrician-gynecologists and other health care providers should ask all pregnant women about recent travel, and women who have traveled to these regions should be evaluated for Zika virus infection,” DeFrancesco advised.
“Because there is no treatment for Zika virus at this time, women should be counseled about all options available to them,” he said. “When possible, delivery at a center with the appropriate levels of neonatal expertise may be warranted,” he suggested.
“Of course, this is an evolving area,” DeFrancesco noted. “We encourage health care providers and patients to continue to monitor the CDC for updated information.”
The U.S. Centers for Disease Control and Prevention has more about the Zika virus.
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