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Review
. 2025 Mar 1;15(3):98.
doi: 10.3390/jpm15030098.

Intrauterine Zika Virus Infection: An Overview of the Current Findings

Ana Luiza Soares Dos Santos  1 , Beatriz Bussi Rosolen  1 , Fernanda Curvelo Ferreira  1 , Isabella Samões Chiancone  1 , Stefany Silva Pereira  1 , Karina Felippe Monezi Pontes  2   3 , Evelyn Traina  2 , Heron Werner  4 , Roberta Granese  5 , Edward Araujo Júnior  1   2
Affiliations
Review

Intrauterine Zika Virus Infection: An Overview of the Current Findings

Ana Luiza Soares Dos Santos et al. J Pers Med. .

Abstract

Zika virus (ZIKV) is a mosquito-borne flavivirus of the family Flaviviridae. The association between ZIKV and microcephaly was first described in Brazil in 2015. The risk of vertical transmission occurs in pregnant women with or without symptoms, and the risk of malformation appears to be worse when infection occurs in the first and second trimesters of pregnancy. The rate of vertical transmission varies from 26 to 65%, and not all fetuses develop malformations. The incidence of malformations resulting from transmission is uncertain, ranging from 6-8% in the US to 40% in Brazil. Congenital ZIKV syndrome is a set of clinical manifestations that can affect the fetus of a mother infected with ZIKV. The manifestations are broad and nonspecific, including microcephaly, subcortical calcifications, ocular changes, congenital contractures, early hypertension, and pyramidal and extrapyramidal signs. Other findings such as growth restriction and fetal miscarriage/death may also occur. Our aim in this article is to review the literature on mosquito transmission, clinical presentation, serologic diagnosis, intrauterine transmission, pre- and postnatal imaging diagnostic findings, and short- and long-term follow-up.

Keywords: Zika virus; fetal malformations; imaging diagnostic methods; intrauterine infection; pregnancy; vertical infectious disease transmission.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Zika virus sylvatic and urban transmission cycles.
Figure 2
Figure 2
Prenatal ultrasound (37 weeks) axial view findings showing periventricular calcifications (arrows) and ventricular dilatation (*). Note normal cerebellum.
Figure 3
Figure 3
Magnetic resonance imaging axial T2-weighted and diffusion-weighted magnetic resonance imaging at 37 weeks, showing ventricular dilatation (*) and smoothness of the brain surface (arrow). Note normal cerebellum.
Figure 4
Figure 4
Coronal and sagittal plane (T2-weighted magnetic resonance imaging) showing smoothness of the brain surface (white arrow). Note microcephaly and redundant skin fold (black arrow). Ventricular dilatation is clearly seen in the coronal plane (*).
Figure 5
Figure 5
Postnatal computed tomography scan showing parenchymal atrophy, microcephaly, widespread/multiple brain calcifications (arrows), and ventricular dilatation (*).
See this image and copyright information in PMC

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