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Postnatal Management of Pregnant Women with Laboratory Evidence of Confirmed or Probable Zika Virus Infection

Should infants born to women with laboratory evidence of Zika virus infection be tested?

Zika virus testing is recommended for infants born to women with laboratory evidence of confirmed or probable Zika virus infection regardless of the presence or absence of phenotypic abnormalities.

The use of cord blood to diagnose other congenital viral infections can yield inaccurate results (e.g., maternal blood contamination; presence of Wharton’s jelly in umbilical cord; and clotted cord blood samples). While collection and testing of cord blood for Zika virus can be performed, these results should be interpreted in conjunction with results of testing of infant serum.

Pathologic evaluation of fetal tissue specimens (e.g., placenta and umbilical cord), is another important diagnostic tool to establish the presence of maternal or congenital Zika virus infection and can provide a definitive diagnosis of Zika virus infection among pregnant women whose serology results indicate recent unspecified flavivirus infection. In addition, findings from pathologic evaluation might also be helpful in evaluating pregnant women who seek care >12 weeks after symptom onset or possible exposure.