Prenatal diagnosis of fetal cytomegalovirus infection

Lamy, M; Mulongo, K N; Gadisseux, Jean-François; Lyon, G; Gaudy, V.; Lierde, M. Van

doi:10.1016/0002-9378(92)91836-y

Cited by 85 publications

(38 citation statements)

References 8 publications

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“…Therefore fetal blood and AF seem to be two logical choices of bodily fluid for the prenatal diagnosis of CMV transmission [46,[75][76][77][78][79][80][81][82][83][84][85][86]. We and others have compared AF and fetal blood and found similar results that strongly support the use of AF [46,78,[81][82][83][84][85][86].…”

Section: Materials To Be Used For Prenatal Diagnosissupporting

confidence: 63%

New Advances in the Diagnosis of Congenital Cytomegalovirus Infection

Lazzarotto¹,

Varani²,

Gabrielli³

et al. 1999

Intervirology

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With the advances in anticytomegalovirus (anti-CMV) serology, the new recombinant IgM tests seem likely to become the screening tests for pregnant women whose prepregnancy serological status for CMV is unknown. When a woman is found to be IgM-positive, further diagnostic evaluation focused on determining whether this is due to a primary infection should be carried out. Maternal primary infections that were difficult to determine until a few years ago unless documented by seroconversion can now be readily diagnosed from the presence of low-avidity anti-CMV antibody which persists for approximately 20 weeks after primary infection. In primarily infected mothers prenatal diagnosis can be performed between 21 and 23 weeks of gestation, and the amniotic fluid (AF) represents the pathological material of choice to determine intrauterine virus transmission. In AF, the virus can be detected by culture and/or PCR. Both procedures differentiate uninfected from infected fetuses, but cannot predict fetal outcome. The determination of the viral load in AF carried out by quantitative PCR is more promising and could represent an important starting point for preemptive fetal therapy.

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Section: Materials To Be Used For Prenatal Diagnosissupporting

confidence: 63%

New Advances in the Diagnosis of Congenital Cytomegalovirus Infection

Lazzarotto¹,

Varani²,

Gabrielli³

et al. 1999

Intervirology

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“…Lamy et al (149) observed that viral load was very high in fetuses with brain ultrasonographic anomalies. Donner et al (58), although not specifically investigating the issue, found that false-negative results in prenatal diagnosis were consistently associated with low viral load and asymptomatic infections both at birth and during follow-up.…”

Section: Fetal Prognostic Markers Of Hcmv Diseasementioning

confidence: 99%

“…9). However, the utility of IgM determination in fetal blood remains to be fully assessed (58,149,167). In addition, while several studies have established the diagnostic and prognostic value of the determination of viral load in the blood of immunocompromised patients, the clinical significance of the presence of virus and viral components in the blood of fetuses exposed to HCMV has never been fully investigated.…”

Section: Fetal Bloodmentioning

confidence: 99%

“…These nonspecific tests, although per se not very useful as prognostic markers of fetal disease, could help as complementary assays (164). Among the HCMV-specific assays, IgM antibody, which can be determined after 20 weeks of gestation, may be more helpful, even though this assay is known to possess a limited diagnostic value due to its low (20% to 75%) sensitivity (58,149,167).…”

Section: Fetal Bloodmentioning

confidence: 99%

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Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

2002

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Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy

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“…It has been suggested by others that culture and PCR performed on amniotic fluid (AF) results in a diagnostic sensitivity of 80 per cent to 100 per cent (Donner et al, 1993;Hogge et al, 1993;Hohlfeld et al, 1991;Lamy et al, 1992;Lynch et al, 1991;Hagay et al, 1996). In two separate reports a lack of sensitivity of the procedure was described before 21 weeks of gestation (Donner et al, 1994;Mulongo et al, 1995).…”

Section: Introductionmentioning

confidence: 95%