Maternal Zika Virus Infection in the First Trimester and Fetal Stigmata in the Third Trimester

Zika is a flavivirus that is transmitted primarily by the bite of an infected Aedes mosquito. It can also be transmitted by blood transfusion, sexual contact, and from an infected mother to the unborn baby. Zika virus infection is of particular concern in pregnancy as transplacental transmission of the virus has the potential to cause significant fetal morbidity. Ultrasonography plays a pivotal role in the fetal surveillance of a pregnant woman infected with Zika. There have been outbreaks of Zika virus infection in various parts of India, the most recent occurring in Kanpur in November 2021. We report a case of a primigravida who had Zika virus infection during the first trimester of pregnancy but the fetus presented with the sequelae of infection in the third trimester. This report highlights the sonographic red flags for fetal Zika infection and the importance of serial monitoring in pregnant women exposed to Zika virus.