Cytomegalovirus infection in pregnancy

Abstract

Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding. Intrauterine transmission can lead to congenital CMV infection, a leading cause of permanent hearing and vision loss and neurological disability among children. Congenital CMV transmission rates are as high as 50% in women who acquire primary CMV infection during pregnancy, and less than 2% in women with nonprimary infection. There is no licensed CMV vaccine. Good hygiene practices and avoiding intimate contact with young children (e.g., kissing on the mouth and sharing utensils) have been suggested as an approach to prevent maternal primary CMV infection during pregnancy, but remains an unproven method of reducing the risk of congenital CMV infection. Approximately 1 in 10 infants who acquire CMV in utero will have clinical signs at birth, and an additional 10 to 15% will go on to develop late-onset sequelae. Antiviral treatment prenatally and postnatally has not proven effective at preventing congenital or postnatal CMV infection, and is not recommended for routine clinical care. However, antiviral treatment when initiated in the first month of life for symptomatic congenital CMV infection is recommended for improved neurodevelopmental and audiologic outcomes. Birth Defects Research 109:336-346, 2017. © 2017 Wiley Periodicals, Inc.

False Positive Rubella Test In Pregnancy

“…As in this case, the patient had past infection with CMV and recovered that may be presented as flue like illness several weeks ago which could lead to cross reaction with CMV IgG giving false positive rubella IgM. CMV infection may be manifested as flu-like illness with persistent fever and fatigue and sometimes it is asymptomatic [8].…”

Congenital Cytomegalovirus Infection Diagnosis Case 24 Years Later While Following With The Cerebral Palsy Diagnosis

“…Since the incidence of congenital CMV infection parallels maternal seroprevalence, the estimated incidence in developing countries is even higher, between 1 and 5% of all live births [4]. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children [5]. Infected women often present with nonspecific signs and symptoms, but the majority is asymptomatic.…”

“…This study presents a 24-year-old male case diagnosed with congenital CMV infection while following the patient with the case of cerebral palsy, mental retardation and epilepsy diagnosis. Due to the increase in the frequency of attacks, the patient's Brain CT calcifications and Anti CMV IgG 207 [5][6][7][8] were examined.…”

Re: Refining the prognosis of fetuses infected with cytomegalovirus in the first trimester of pregnancy by serial prenatal assessment: a single‐centre retrospective study

“…Amniocentesis is necessary to confirm the CMV infection, but is usually performed at 20–23 weeks, as the elimination of the virus through fetal urine can take an average of 8 weeks from the maternal–fetal infection . Although commonly recommended in clinical practice, we argue that it may be time to revise the role of cordocentesis following a previously performed amniocentesis.…”

“…Although the authors should be appreciated for their predictive model, we do not think it is generalisable to the pregnant population in the health systems of all countries in the world. The usefulness of antenatal care in the third trimester of pregnancy, and in particular of a magnetic resonance imaging scan at 32 weeks, may be questionable because the confirmation of fetal infection does not demonstrate fetal damage, and above all, because there is no prenatal therapy; in fact, therapeutic options, such as antiviral therapy, are being evaluated but their use is still limited to the research setting …”