Document Detail


Prenatal diagnosis of fetal primary cytomegalovirus infection.
MedLine Citation:
PMID:  10645866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the reliability of prenatal diagnosis for congenital cytomegalovirus in women with primary infection. DESIGN: Retrospective analysis of case records between 1992 and 1997. SETTING: Fetal medicine unit of a large teaching hospital. POPULATION: Forty-two pregnant women with primary cytomegalovirus infection. METHODS: Fetal diagnosis was made by amniocentesis for viral culture and amplification of cytomegalovirus DNA by polymerase chain reaction (n = 37), or by cordocentesis for the detection of cytomegalovirus-specific IgM antibodies (n = 13). All patients had serial ultrasonographic scans in order to detect those fetuses with abnormalities that could be associated with cytomegalovirus infection. RESULTS: Fourteen pregnancies (33 x 3%) had evidence of vertical transmission. Nine out of 14 (64 x 3%) had positive amniotic fluid culture, while 11 (78 x 6%) had positive polymerase chain reaction results. The combination of both tests allowed antenatal diagnosis in 12 of the 14 infected fetuses (sensitivity 85 x 7%). All women who underwent cordocentesis for the detection of cytomegalovirus-specific IgM antibodies had negative results, but in two cases cytomegalovirus infection was detected by amniotic fluid studies. In five of the infected fetuses there were abnormal ultrasonographic findings. All pregnancies with evidence of vertical transmission were terminated and the remainder proceeded normally to term. CONCLUSIONS: Our data showed that amniotic fluid studies, preferably polymerase chain reaction amplification of viral DNA, are the best diagnostic tools for the detection of vertical transmission in pregnancies with primary cytomegalovirus infection. For women with positive amniotic fluid studies who elect to continue their pregnancies, cordocentesis and serial ultrasound scans may be useful for assessment of fetal status.
Authors:
A J Antsaklis; G J Daskalakis; S A Mesogitis; P T Koutra; S S Michalas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  107     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-03     Completed Date:  2000-02-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  84-8     Citation Subset:  AIM; IM    
Affiliation:
First Department of Obstetrics and Gynaecology, Fetal Medicine Unit, Alexandra Hospital, University of Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Cytomegalovirus Infections / diagnosis*
DNA, Viral / isolation & purification
Female
Fetal Diseases / diagnosis*
Gestational Age
Humans
Polymerase Chain Reaction / methods
Pregnancy
Prenatal Diagnosis / methods*
Retrospective Studies
Chemical
Reg. No./Substance:
0/DNA, Viral

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