Ultrasound Markers of Fetal Infection Part 1

Abstract

Diagnosis of fetal infection has depended on identification of pathogens by means of microbiological cultures, immunologic techniques, and special molecular biology techniques that can identify organisms known or suspected of being associated with adverse outcomes of pregnancy. Rubella, cytomegalovirus (CMV), herpes simplex virus (HSV), and human immunodeficiency virus (HIV), for example, are capable of gaining access to the amniotic cavity and producing fetal infection, even when amniotic membranes are intact. Intrauterine invasion by viruses can be associated with maternal symptoms of infection or can be completely silent. In many instances extensive fetal compromise with irreversible structural damage or fetal death will have occurred by the time infection is confirmed by culture or other histopathological methods. The evidence of fetal infection may be as subtle as nascent intrauterine growth restriction (IUGR), mildly inappropriate calcification of fetal organs, placenta, cord, and membranes, and failure to adequately develop fetal fat reserves. The evidence of infection may be as dramatic as obvious fetal malformation, severe central nervous system structural damage, or fetal death. Sonography is capable of detecting most of the grave alterations and some of the subtle effects that are typical of fetal infection.

Slc20a2 deficiency results in fetal growth restriction and placental calcification associated with thickened basement membranes and novel CD13 and lamininα1 expressing cells

“…Placental calcification has been associated with poor pregnancy outcomes [32–34]. In order to determine whether calcification was present in preeclampsia placentas, we obtained anterior and posterior ( n = 3) human placental specimens.…”

“…Human placentas have been reported to develop calcification, and placental calcification has been associated with pregnancy complications, such as viral infection [32–34]. Despite this, placental calcification pathology and impact on maternal health are poorly understood.…”

Characterization of stem cells in Dupuytren's disease

“…Congenital infection can be a cause of mild VM, and possible pathogens include Toxoplasma , cytomegalovirus (CMV) and rubella. There is a wide variation in the incidence of infection as the underlying cause, depending on the population studied17, 33–35.…”

When are amniotic fluid viral PCR studies indicated in prenatal diagnosis?

“…Traditional markers of infection included echogenic bowel, defined as fetal bowel with homogenous areas of echogenicity that are equal to or greater than that of surrounding bone and classified as either focal or multifocal; echogenic liver; pleural or pericardial effusions; or ascites …”