Screening for Cytomegalovirus Infection During Pregnancy in a Teaching Hospital, Western province, Sri Lanka

Abstract

Primary Cytomegalovirus (CMV) infection during pregnancy is a serious threat to the fetus. Although vertical transmission is likely to occur as a result of maternal infection, the rate of permanent sequelae is higher among infants born to mothers with primary CMV infection. Diagnosis of CMV infection among healthy adults generally relies on serological testing as most of them are asymptomatic. CMV infection in pregnancy is barely studied in Sri Lanka. This study aims in screening for CMV infection of selected pregnant population in a major maternity hospital and to describe associated factors with seropositivity. This study included 385 pregnant women in second trimester presented during a period of 6 months. Mothers with immunocompromised states were not recruited. Questionnaire was used to gather sociodemographic and clinical factors. All serum samples were tested for CMVIgG and IgG-avidity assay for seropositives. CMV-IgM test was carried out on samples with negative CMV-IgG and low/equivocal-avidity levels. All 3 seromarkers were tested using commercial Enzyme Linked Immunosorbent Assays. Data were analyzed by SPSS. Majority (97%) of the population were positive for CMV-IgG. CMV-avidity was low, equivocal or high in 0.25%, 2.75% and 97% of IgG seropositives respectively. Age, bad obstetric history and multiparity didn't show association with IgG seropositivity. In conclusion, CMV seroprevalence was high in this study population with low rates of recent primary infection. Education regarding preventive measures for CMV infection in antenatal care has a value as some proportion were seronegative for CMV with prone to get new infections.

Prognostic factors and outcomes of Kasai portoenterostomy (KPE): nine-year experience from a lower-middle income country

“…Majority of our sample have not received adjuvant steroids which have shown to improve jaundice clearance [12,13]. Studies have shown in CMV -associated biliary atresia COJ can be as low as 15% [14] .Exact prevalence of congenital CMV infection in Sri Lanka is not known but postulated to be much higher than in western countries [15]. We have made an observation that many episodes of cholangitis going undetected in early postoperative period under the umbrella term "Post-op fever" without prompt and aggressive antibiotic treatment.…”