Yarrington Christina D, Hamer Davidson H, Kuohung Wendy, Lee-Parritz Aviva
1Department of Obstetrics and Gynecology, Division of Maternal & Fetal Medicine, Boston Medical Center, Boston, MA 02118 USA.
2Boston Medical Center Department of Medicine, Section of Infectious Diseases, Boston University School of Public Health Department of Global Health and Center for Global Health and Development, Boston, MA USA.
Fertil Res Pract. 2019 Jan 3;5:1. doi: 10.1186/s40738-018-0053-5. eCollection 2019.
Sexual transmission of Zika virus is well documented and pregnant women are advised to abstain or use barrier protection if a sexual partner has risk for Zika infection. However, to date there has not been a documented case of the congenital Zika syndrome resulting from sexual transmission.
A 32 year-old woman who had not traveled to any area with local Zika transmission in years became pregnant via frozen embryo transfer. Her husband traveled to Haiti several times prior to embryo transfer and during the pregnancy. Neither partner was ever symptomatic. In her second trimester when recommendations were published by the Centers for Disease Control and Prevention (CDC) regarding prevention of sexual transmission during pregnancy she was counseled to abstain or use barrier protection with her partner. At delivery, the infant head circumference measured less than the first percentile. Placental samples were sent to the CDC and all were positive for Zika RNA by RT-PCR. Evaluation for other causes of microcephaly was negative. Consistent with the most up to date diagnostic parameters for congenital Zika, including viral infection of the placenta, the baby was diagnosed with congenital Zika syndrome.
Transmission via sexual contact during assisted reproductive therapies (ART) and pregnancy can result in Zika fetopathy. This case supports recommendations to counsel women undergoing ART and pregnant women to use barrier protection with partners with Zika exposure regardless of their symptoms.
寨卡病毒的性传播已有充分记录，建议孕妇在性伴侣有寨卡病毒感染风险时 abstain 或采取屏障保护措施。然而，迄今为止，尚无因性传播导致先天性寨卡综合征的记录病例。
一名32岁女性多年来未曾前往有寨卡病毒本地传播的任何地区，通过冷冻胚胎移植怀孕。她的丈夫在胚胎移植前及怀孕期间多次前往海地。双方均未曾出现症状。在她妊娠中期，美国疾病控制与预防中心（CDC）发布了关于孕期预防性传播的建议，她接受了咨询，被告知要 abstain 或与伴侣采取屏障保护措施。分娩时，婴儿头围小于第一百分位数。胎盘样本被送往CDC，所有样本经逆转录聚合酶链反应（RT-PCR）检测寨卡病毒核糖核酸（Zika RNA）均呈阳性。对小头畸形的其他病因评估为阴性。根据先天性寨卡最新诊断参数，包括胎盘病毒感染，该婴儿被诊断为先天性寨卡综合征。
辅助生殖技术（ART）及孕期通过性接触传播可导致寨卡胎儿病。本病例支持向接受ART的女性及孕妇提供咨询建议，即无论其性伴侣有无症状，只要有寨卡病毒暴露风险，均应采取屏障保护措施。
