Fetus-Placenta-NewbornPrenatal diagnosis of symptomatic congenital cytomegalovirus infection☆,☆☆
Section snippets
Study population
In a number of Italian regions, pregnant women undergo routine CMV screening before the 12th week of gestation with commercially available kits for both anti–CMV immunoglobulin G (IgG) and anti–CMV immunoglobulin M (IgM). Seronegative women are reassessed after 16 to 18 weeks' gestation and during the third trimester. The women who have seroconversion and those who are IgM-seropositive are referred for further diagnostic evaluation.
During the last 5 years (1994-1998) 2 serum samples taken from
Results
With the exception of 5 patients in the third trimester amniocentesis was offered to all the women with primary infection (n = 138), 68 of whom (49.2%) followed our advice mainly in the hope of continuing the pregnancy with more confidence in the case of a negative result. In particular, amniocentesis was promptly accepted by 4 women with abnormal ultrasonographic findings to allow further investigation. The remaining 50.8% did not choose to undergo this procedure, mainly because we admitted
Comment
In this study the quantitative PCR determination of amniotic fluid viral load predicted both the infectious and the clinical outcomes of maternal CMV infection in fetuses and neonates. These findings may help clinicians to counsel pregnant women infected by CMV about the likely outcome for the offspring and enable the women themselves to decide the future of the pregnancy on a more informed basis.
The aim of prenatal diagnosis is to distinguish infected from uninfected fetuses, for which the
Acknowledgements
We thank Kevin Smart (LINK, Milan, Italy) for his help in preparing the manuscript.
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2018, Seminars in PerinatologyCitation Excerpt :Amniocentesis to perform PCR for CMV DNA in the amniotic fluid is the preferred diagnostic approach for identifying an infected fetus.50–53 Timing of amniocentesis is critical since the sensitivity for detection of CMV is higher after 21 weeks of gestation.50–52 If amniocentesis is performed earlier in gestation or soon after diagnosis of maternal infection, it is only reliable evidence of fetal infection if positive, and should be repeated later in gestation if negative.
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Supported in part by grants from the Ministry of Public Health (Instituto Superiore di Sonite, AIDS Project), the Ministry of Education, Scientific and Technological Research, and the University of Bologna.
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Reprint requests: Brunella Guerra, MD, PhD, Clinica Ostetrica e Ginecologica II, Policlinico S. Orsola, Via Massarenti 13, 40138 Bologna, Italy.