Zika virus: review and obstetric anesthetic clinical considerations

• Published in: Journal of clinical anesthesia Vol. 35; pp. 136 - 144
• Main Authors: Padilla, Cesar, Pan, Aileen, Geller, Andrew, Zakowski, Mark I.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2016; Elsevier Limited
• Subjects: Aedes - virology; Anesthesia; Anesthesia & Perioperative Care; Anesthesia, Obstetrical - methods; Anesthetic considerations; Animals; Blood-Borne Pathogens; Dengue fever; Disease control; Encephalitis; Female; Guillain-Barre syndrome; Guillain-Barre Syndrome - complications; Guillain-Barre Syndrome - epidemiology; Guillain-Barre Syndrome - virology; Guillain-Barré; Humans; Incidence; Infections; Infectious Disease Transmission, Vertical - prevention & control; Medical personnel; Microcephaly; Mosquitoes; Obstetrics; Olympic games; Pain; Pain Medicine; Patients; Physicians; Pregnancy; Transmission prevention; Tropical diseases; United States - epidemiology; Uteroplacental insufficiency; Womens health; Zika virus; Zika Virus - pathogenicity; Zika Virus Infection - complications; Zika Virus Infection - epidemiology; Zika Virus Infection - prevention & control; Zika Virus Infection - transmission; Brazil; United States > US; Africa; Guillain-Barré; Anesthetic considerations; Transmission prevention; Zika virus; Uteroplacental insufficiency
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2016.07.034

To review the clinical and basic science literature regarding Zika viral illness and highlight relevant findings for obstetric anesthesiologists. This review provides a global review of Zika viral illness, transmission patterns, pathophysiology of disease, and anesthetic management of the parturient with Zika viral illness and associated comorbidities. Systematic review. Large academic hospital. None. None. None. None. With the rapid spread of Zika virus and expected increase of spread in the summer of 2016, this review provides anesthesiologists with current recommendations, physiologic alterations, and anesthetic considerations in regard to the parturient with Zika viral illness and associated diseases. •Zika virus infection and clinical disease states are reviewed.•Transmission patterns of Zika virus are reviewed; note possible widespread local activity in North America in the summer months of 2016.•In utero transmission and pathophysiology of Zika viral disease in the developing fetus are discussed in relation to maternal and fetal effects and possible clinical presentations.•Fetal effects of the maternal Zika virus transmission may be related to placenta inflammation, placental insufficiency, altered immune function, and impaired production of neuropeptide and growth factors.•Anesthetic considerations for the parturient with active Zika viral infection including possible thrombocytopenia and associated diseases including Guillain-Barré are reviewed.•Current Centers for Disease Control and Prevention recommendations for prevention of transmission within labor and delivery.