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Periconceptional cytomegalovirus infection: pregnancy outcome and rate of vertical transmission
Author(s) -
Hadar Eran,
Yogev Yariv,
Melamed Nir,
Chen Rony,
Amir Jacob,
Pardo Josef
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2654
Subject(s) - amniocentesis , medicine , pregnancy , obstetrics , cytomegalovirus , abortion , amniotic fluid , gynecology , fetus , prenatal diagnosis , viral disease , herpesviridae , immunology , biology , virus , genetics
Objective To evaluate pregnancy outcome and rate of vertical transmission in primary maternal periconceptional cytomegalovirus (CMV) infection. Methods All women serologically diagnosed with primary periconceptional CMV infection between 1999 and 2008 were included. Periconceptional infection was defined as primary maternal CMV infection occurring within 4 weeks prior to the last reported menstrual period and up to 3 weeks following the expected date of the missed menstrual period. Intrauterine infection was verified by PCR and shell vial culture of amniotic fluid at 22–24 weeks or neonatal urine culture within 48 h of birth. Results Of the 59 patients studied, 43 (73%) underwent diagnostic amniocentesis. Eleven of the 43 patients (25.5%) were positive for CMV contamination. Ten of the 11 patients (90%) elected to terminate pregnancy. Twelve women (20.3%) declined amniocentesis: of these 2 elected to undergo a first‐trimester termination of pregnancy and 10 gave birth to a live‐born infant. Six of the ten neonates were negative for CMV and two tested positive for urinary CMV; all eight were healthy on long‐term follow‐up, and two were lost to follow‐up. The remaining four women had a spontaneous first‐trimester abortion. Conclusion The risk of transmission of periconceptional CMV infection is lower than previously reported. These data should be borne in mind when counseling affected couples. Copyright © 2010 John Wiley & Sons, Ltd.