Original ArticlesPrenatal indicators of congenital cytomegalovirus infection☆,☆☆
Section snippets
Methods
As a CMV referral center, we have adopted a 3-step diagnostic protocol. The first step, based on serologic tests, was aimed at identifying the presence of primary and recurrent infection. This step included the following serologic tests carried out on at least 1 pair of serum samples from each woman: redetermination of CMV-specific IgG and IgM by enzyme immunoassay,19 determination of the avidity of anti-CMV IgG (cytomegalovirus IgG avidity EIA WELL; RADIM, Rome, Italy),10 and confirmation of
Results
Between March 1994 and July 1998, we tested the sera of 456 pregnant women that were identified by screening laboratories of several Italian regions. No active infection was observed in 220 cases, a diagnosis of recurrent infection was made in 106 cases, a diagnosis of primary infection was made in 110 women, whereas no indication of the type of infection was obtained in 20 cases (“undefined”).
We offered amniocentesis to all women with primary or undefined infection, and 44% accepted. The main
Discussion
The diagnostic protocol adopted in this study accurately predicted both infection and clinical presentation of maternal CMV infection on the fetus or newborn. The 3-step protocol sequentially filters mothers and fetuses at high risk. Primary CMV infections that were difficult to detect until recently can now be diagnosed by disclosing presence of the low avidity anti-CMV antibody that persists for ”20 weeks after primary infection.10
We and others carried out invasive prenatal diagnosis, mainly
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2021, Journal of Obstetrics and Gynaecology CanadaCytomegalovirus infection in pregnancy – An update
2021, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :If the fetus is infected and ultrasound does not show an abnormality, determination of viral load in amniotic fluid may help to distinguish those who will be asymptomatic at birth from those who are likely to be symptomatic and at high risk of developing serious sequelae [3,69,70]. A study of 456 women at weeks 21–23 of pregnancy for example, found that higher viral loads in amniotic fluid (>100,000 copies/mL) were associated with symptomatic new-borns [3,70]. In another small study of 21 fetuses, the median DNA level in amniotic fluid was higher in symptomatic newborns, but the difference was not statistically significant [71].
Maternal infections
2020, Handbook of Clinical NeurologyFetal Infections
2019, Fetal Medicine: Basic Science and Clinical Practice
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Supported in part by grants from the ministry of public health (ISS, AIDS projects), the Ministry of University, Scientific and Technological Research and the University of Bologna.
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Reprint requests: Maria Paola Landini, MD, PhD, Laboratorio Di Microbiologia E Virologia, Policlinico S. Orsola-Malpighi, via Massarenti N. 9, 40138 Bologna, Italy.