(Choice E) Vertical transmission of varicella-zoster virus results in congenital varicella syndrome, which can cause growth restriction but typically presents with limb abnormalities (eg, bone/muscle hypoplasia).
Congenital rubella syndrome can cause fetal growth restriction and hepatomegaly. However, this is unlikely in patients with a current vaccination status and immunity to rubella (positive IgG) on first-trimester screening.
(Choice F) Congenital syphilis from a Treponema pallidum infection can cause fetal intracranial and intrahepatic calcifications. Although this patient has a positive rapid plasma reagin, the confirmatory treponemal antibody absorption test is negative, making this diagnosis unlikely.
(Choice E) Travel to tropical, mosquito-infested regions increases the risk of maternal Zika virus infection, which crosses the placenta and impairs fetal brain development. Affected fetuses may have microcephaly, ventriculomegaly, or intracranial calcifications on ultrasound. This patient's fetal biparietal diameter and head circumference are normal.