While there have been no reported cases of pregnant women with the Zika virus, the Ministry of Public Health has decided to classify those who display Zika-like symptoms as being high-risk pregnancies, ensuring that they will be monitored more closely.
This disclosure was made yesterday by Director of the Maternal and Child Health Department Dr Earthanesia Hamilton during an interview with Stabroek News. She said that once a pregnant woman exhibits Zika-like symptoms, that is, fever, rash and/or conjunctivitis, the pregnancy would be considered to be a high-risk pregnancy.
Dr Hamilton emphasised the importance of family planning and antenatal care. “Our message to women of reproductive age going forward is that as soon as you miss a period, or as soon as you have a positive pregnancy test, we want you to get enrolled at a clinic. This provides us with the opportunity to do better monitoring while you get better results,” she said.
She pointed out that early enrollment at antenatal clinics has always been promoted prior to the occurrence of the Zika virus locally. The health official said the management of the mosquito-borne virus would pattern the procedures done at the clinics.
“It’s the normal clinic that you would go through, just that monitoring would be more focused and then we want to make sure that once these mothers come within the specific period that they experience the symptoms, we will take off your sample and send it to be tested,” she said.
As it relates to the possibility of a child being born with Microcephaly – a rare birth defect said to be linked to the Zika virus which results in the baby being born with a small head or the head stops growing after birth – Hamilton was quick to point out that not every Zika-infected pregnant woman would give birth to a child with the condition.
“Microcephaly is something that’s been around for a very long time. Even before the Zika virus existed locally, we have had cases of microcephaly, not a lot maybe one or two per year in Guyana…You can have a child being born with a small head that doesn’t have microcephaly but based on that child’s DNA make up, the child’s head is small,” Dr Hamilton said.
She emphasised that once a pregnant woman displays Zika-like symptoms, it is the expectation that the monitoring would more intensive than compared to a normal pregnancy.
The World Health Organization (WHO) has said that there are no specific tests to determine if a baby will be born with microcephaly but ultrasound scans in the third trimester of pregnancy can sometimes identify the problem. Dr Hamilton related that pregnant women with the Zika virus would be required to undergo frequent ultrasounds in order to measure the circumference of the foetus’s head.
In the meantime, she said, there are already mechanisms in place to address the occurrence of babies born with microcephaly including psychosocial support and referrals for rehabilitation services as well as additional specialised support for both parent and child.
“The system is set up in such a way that for these children who would more than likely be born with deficits or a delay in development, as long as they are recognised by the clinic, they would be referred to the centre,” the health official said even as she continued to emphasise the importance of women attending clinic regularly.
“Every single month, a baby does something different that is normal along the developmental cycle…this month he may turn over, the next month he may start getting teeth. All of those things are attached to an age, so if you’re going to clinic as you’re supposed to, by following the normal cycle of development, it is easier for parents and medical personnel to pick up if something is wrong,” she said.
Meantime, the Director revealed that the Department of Maternal and Child Health plans to introduce a medical form – designed to be used as a guideline for the monitoring of pregnant women – as part of a pilot initiative to be launched next month. She said the plan has already been presented to a support team consisting of ultra-sonographers, paediatricians, obstetricians and gynaecologists, all of whom were invited to make an input regarding the contents of the medical form.
“We haven’t sent it out to all the hospitals as yet but we invited them so that they can see the guidelines and they can, in turn, give us their input on what might need to be changed and what is more feasible. We also had officers including myself who received training from WHO on what are the areas that need to be covered for Zika,” Hamilton related.
The surge in Zika-related cases has resulted in some countries like Jamaica, Colombia and Brazil requesting their female population to delay pregnancy but Hamilton said once persons properly consider the benefits of family planning, this should not be the case for Guyana.
“Going forward, we are not telling anyone to delay pregnancy. We are actually telling persons to plan your pregnancy better in the sense that if you know you want to become pregnant, you take all your precautionary measures to make sure you do not get infected with Zika which is the same thing as in a normal case,” she stated.
According to Hamilton, these measures include destroying mosquito breeding sites within the immediate environment, utilising insect repellent and mosquito nets as well as wearing light-colored, long-sleeve clothing. The health official added that her team is working assiduously to not only promote, but increase their family planning services countrywide.