(CNN)Zulmarys Molina arrives at the high-risk pregnancy clinic in San Juan, Puerto Rico, shortly after dawn, excited to see her baby.
Inside the examining room, she raises her shirt so Dr. Alberto de la Vega can put an ultrasound wand on her belly.
He heads straight for the baby’s brain.
Abortion decisions are never easy, but with Zika, there’s an added element of difficulty: The brain damage caused by the virus doesn’t seem to show up until relatively late in the pregnancy, when it’s more complicated, medically and emotionally, to end a pregnancy.
With the patient in Washington, her baby’s brain defects didn’t appear until 19 weeks, nearly halfway through the pregnancy. The parents decided to terminate two weeks later.
“This was a very difficult decision for them to make,” said the woman’s obstetrician, Dr. Rita Driggers, an associate professor of gynecology and obstetrics at Hopkins.
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With another patient, also reported in the New England Journal of Medicine, the defects didn’t show up until even later — 29 weeks. That mother also chose to terminate her pregnancy.
Molina’s next ultrasound is April 13. She awaits it with some anxiety.
“But I am feeling very positive,” she says. “I know everything will be OK.”
CNN’s Debra Goldschmidt and John Bonifield contributed to this report.