Primary maternal cytomegalovirus infections: accuracy of fetal ultrasound for predicting sequelae in offspring

Leyder, Mina; Vorsselmans, Anniek; Doné, Elisa; Berkel, Kim Van; Faron, Gilles; Foulon, Ina; Naessens, Anne; Jansen, Anna; Foulon, Walter; Gucciardo, Léonardo

doi:10.1016/j.ajog.2016.06.003

Cited by 41 publications

(39 citation statements)

References 25 publications

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“…Hence, the false negative culture result can be explained by the short time interval between seroconversion and AC. A high concordance between viral culture and PCR was also reported by Leyder et al (100%), 25 Feldman et al (100%), 19 and Gouarin et al (98.9%). 26 In the latter study, the only discrepancy was a PCR-positive/ culture-negative finding in a child uninfected at birth resulting in a slightly superior specificity of the culture method.…”

Section: Discussionsupporting

confidence: 72%

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Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases: a 5 years' single center experience

Enders¹,

Daiminger²,

Exler³

et al. 2017

Prenatal Diagnosis

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Section: Discussionsupporting

confidence: 72%

“…A high concordance between viral culture and PCR was also reported by Leyder et al . (100%), Feldman et al . (100%), and Gouarin et al .…”

Section: Discussionmentioning

confidence: 96%

Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases: a 5 years' single center experience

Enders¹,

Daiminger²,

Exler³

et al. 2017

Prenatal Diagnosis

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show abstract

“…If the diagnosis of maternal and fetal infection by amniocentesis has already been established, regular US assessment every 3 to 5 weeks is recommended to detect signs of symptomatic fetal infection. Discordant results from several studies on US predictivity were reported for clinical outcomes of infected fetuses (41,42), suggesting that the timing for US execution and transient fetal morphological features might critically influence the diagnosis. In fact, at present, only severe cranial abnormalities, such as ventriculomegaly and microcephaly, have been unequivocally associated with poor prognoses (43).…”

Section: Prenatal Diagnosis Of Ccmvmentioning

confidence: 65%

Testing for Cytomegalovirus in Pregnancy

et al. 2017

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Congenital cytomegalovirus (CMV) infection represents a relevant cause of deafness and neurological damage in newborns. Intrauterine CMV transmission might result after primary or nonprimary infections, though at different rates (30% versus 0.2%, respectively). At present, a prenatal diagnosis of CMV infection is based mainly on maternal serology, the detection of CMV-DNA in amniotic fluid and fetal blood, and ultrasound (US) and magnetic resonance imaging (MRI). Recent evidences suggest that congenital CMV infection may be an immune-mediated disease and that evaluation of humoral and especially T-cell immunities may improve the overall prenatal diagnosis. This review summarizes the most recent advancements in the diagnosis of maternal and prenatal CMV infections.KEYWORDS human cytomegalovirus, laboratory assays, congenital infections, IgG avidity, CMV-ELISPOT, CMV-QuantiFERON, immunoserology, imaging T he human cytomegalovirus (CMV) is a ubiquitous betaherpesvirus causing morbidity and mortality in immunocompromised patients and congenitally infected fetuses and newborns, resulting in a broad range of disabilities, including sensorineural hearing loss (SNHL), visual impairment, and motor and cognitive deficits. Other transient symptoms of congenital CMV infection (cCMV) may include hepatosplenomegaly, thrombocytopenia, and jaundice. The global prevalence of cCMV has been estimated at 0.7% (1), and fetal CMV transmission may arise from a maternal primary or nonprimary infection. The highest rate of cCMV occurs after primary infections in seronegative mothers (30 to 40%), while nonprimary infections, including CMV reactivations or reinfections, result in cCMV in 0.2 to 2% of cases, suggesting that preconceptional immunity may play a role in preventing intrauterine transmission (2). If the main burden of congenital infections in Europe and North America results from primary infections, then nonprimary infections represent the main cause of cCMV in developing countries or in poor socioeconomical contexts, since the seroprevalences among the resident populations are much higher (3). The severities of infections in neonates and infants are highly variable. It has been estimated that 10 to 15% of congenitally infected neonates are symptomatic at birth, and 40 to 58% of them will experience permanent long-term sequelae. Moreover, 13.5% of children with asymptomatic infections will develop late-onset sequelae, mainly consisting of hearing impairments and neurologic deficits. The effectiveness of antiviral treatment during pregnancy is still debated. Most of the concerns are related to the potential genotoxicity and teratogenicity of the drugs. The clinical benefits of CMV-specific hyperimmune globulin treatment are also disputed, due to discordant results obtained from different studies (4,5).In the last decade, major efforts have been made to improve the early laboratory diagnosis of maternal and fetal infections. Despite these efforts, at present, many countries in the world have not yet adopted a consolidate...

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“…A recent study has shown that the predictive ability of prenatal ultrasonography increases dramatically in a population at higher prevalence of congenital CMV infection, namely, women with primary CMV infection at <20 weeks of gestation and proven fetal transmission via amniocentesis. The positive predictive value of ultrasonographic central nervous system anomalies was 83% for clinical impairment, and the negative predictive value 72% . The negative predictive value of ultrasonography increases to 93% at the time of prenatal diagnosis of fetal infection if non‐severe ultrasound features are also absent .…”

Section: Neurotropic Virusesmentioning

confidence: 98%

“…The positive predictive value of ultrasonographic central nervous system anomalies was 83% for clinical impairment, and the negative predictive value 72%. 38 The negative predictive value of ultrasonography increases to 93% at the time of prenatal diagnosis of fetal infection if non-severe ultrasound features are also absent. 39 Such information can be incorporated into published algorithms for patient counseling following diagnosis of CMV infection.…”

Section: Cytomegalovirusmentioning

confidence: 99%

In case you missed it: thePrenatal Diagnosiseditors bring you the most significant advances of 2016

et al. 2017

View full text Add to dashboard Cite

Primary maternal cytomegalovirus infections: accuracy of fetal ultrasound for predicting sequelae in offspring

Cited by 41 publications

References 25 publications

Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases: a 5 years' single center experience

Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases: a 5 years' single center experience

Testing for Cytomegalovirus in Pregnancy

In case you missed it: thePrenatal Diagnosiseditors bring you the most significant advances of 2016

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