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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

9 Issues per year


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1619-3997
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Guidelines on CMV congenital infection

Oriol Coll
  • Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain
/ Guillaume Benoist
  • Department of Obstetrics and Fetal Medicine, Hospital Necker-Enfants-Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
/ Yves Ville
  • Department of Obstetrics and Fetal Medicine, Hospital Necker-Enfants-Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
/ Leonard E. Weisman
  • Department of Pediatrics at Baylor College of Medicine, and Perinatal Center at Texas Children's Hospital, 6621 Fannin Street Suite FC830.19, Houston, TX 77030-2303, USA
/ Francesc Botet
  • Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain
/ the WAPM Perinatal Infections Working Group: Maurizio M. Anceschi
  • Department of Gynecology and Obstetrics, “Sapienza” University of Rome, 1 Faculty of Medicine, Policlinico Umberto I, I00161 Rome, Italy
/ Anne Greenough
  • Neonatal Intensive Care Unit, London School of Medicine, King's College, 4th Floor Golden Jubilee Wing King's College Hospital, Denmark Hill London, SE5 9RS, UK
/ Ronald S. Gibbs
  • Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, CO 80262, USA
/ Xavier Carbonell-Estrany (coordinator)
  • Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain
Published Online: 2009-08-13 | DOI: https://doi.org/10.1515/JPM.2009.127

Abstract

Congenital cytomegalovirus (CMV) infection occurs in 0.6–0.7% of all newborns and is the most prevalent infection-related cause of congenital neurological handicap. Vertical transmission occurs in around 30% of cases, but the fetus is not always affected. Symptomatic newborns at birth have a much higher risk of suffering severe neurological sequelae. Detection of specific IgG and IgM and IgG avidity seem to be the most reliable tests to identify a primary infection but interpretation in a clinical context may be difficult. If a seroconversion is documented or a fetal infection is suspected by ultrasound markers, an amniocentesis should be performed to confirm a vertical transmission. In the absence of a confirmed fetal infection with fetal structural anomalies, a pregnancy termination should be discouraged. Fetal prognosis is mainly correlated to the presence of brain damage. Despite promising results with the use of antiviral drugs and CMV hyperimmune globulin (HIG), results have to be interpreted with caution. Pregnant women should not be systematically tested for CMV during pregnancy. Managing CMV screening should be restricted to pregnancies where a primary infection is suspected or among women at high risk. The magnitude of congenital CMV disease and the value of interventions to prevent its transmission or to decrease the sequelae need to be established before implementing public health interventions. In this paper, aspects of CMV infection in the pregnant woman and her infant are reviewed.

Keywords: Amniotic fluid (AF); congenital cytomegalovirus (CMV); polymerase chain reaction (PCR)

Corresponding author: Oriol Coll, MD, PhD Department of Maternal-Fetal Medicine Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Hospital Clinic, University of Barcelona Barcelona Spain Tel.: +34-93.227.54.00 Fax: +34-93.227.56.05


Published Online: 2009-08-13

Published in Print: 2009-09-01


Citation Information: Journal of Perinatal Medicine. Volume 37, Issue 5, Pages 433–445, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2009.127, August 2009

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