Prenatal Diagnosis of Fetal Primary Cytomegalovirus Infection

Obstet Gynecol. 1997 May;89(5 Pt 1):763-7. doi: 10.1016/s0029-7844(97)00084-7.

Abstract

Objective: To evaluate the validity of prenatal diagnosis work-up for congenital cytomegalovirus (CMV) in women with primary infection.

Methods: Sixty-three pregnant women with primary cytomegalovirus disease (including two with twin pregnancies), referred to three tertiary perinatal centers over 4 years, underwent evaluation for congenital cytomegalovirus. Fetal diagnosis was made after 21 weeks' gestation by amniocentesis and fetal blood sampling (40 subjects), or amniocentesis only (23 subjects).

Results: Twenty-two (35%) pregnancies showed evidence of vertical transmission: 13 of them underwent funipuncture, but only ten (77%) of the 13 showed positive immunoglobulin (Ig)-M results in fetal blood. No cases of positive fetal serum Ig-M with negative amniotic fluid culture or polymerase chain reaction were observed. In nine (41%) of the 22 pregnancies with evidence of vertical transmission, abnormal ultrasonographic findings were recorded. Six (27%) women with evidence of vertical transmission continued their pregnancies and in only one (with prenatal ultrasonographic abnormalities) was an infant born with neurologic sequelae. In 41 (65%) pregnancies, no evidence of vertical transmission was found, and 37 continued to term. Only one newborn from this subgroup subsequently showed mild motor disability during a median of 23 months of follow-up.

Conclusion: Among pregnant patients with primary CMV infection, analysis of amniotic fluid detected all of the infected fetuses. Thus, this is a reliable tool for counseling pregnant women with primary infection. This may guide the patient as to whether or not pregnancy can be continued with a high level of confidence.

MeSH terms

  • Amniocentesis
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / congenital*
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / transmission
  • Developmental Disabilities / virology
  • Female
  • Fetal Diseases / diagnosis*
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Prenatal Diagnosis / standards*
  • Reproducibility of Results
  • Ultrasonography, Prenatal