First-line noninvasive management of cytomegalovirus primary infection in  pregnancy.

Abortion, Induced; Adult; Amniocentesis; Brain/diagnostic imaging; Cytomegalovirus Infections/diagnosis/therapy; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications, Infectious/diagnosis/therapy; Ultrasonography, Prenatal; amniocentesis (AC); cytomegalovirus(CMV); magnetic resonance imaging (MRI); pregnancy; primary infection; ultrasound

Abstract :

[en] OBJECTIVES: To introduce a first-line noninvasive antenatal management of maternal cytomegalovirus (CMV) primary infection based on ultrasound (US) and magnetic resonance imaging (MRI). Amniocentesis (AC) is used as a second-line tool in cases of abnormalities compatible with fetal CMV infection on US and/or MRI screening. METHODS: Between January 2011 and October 2018, pregnant women referred with a CMV primary infection on antibody screening were followed up by monthly US scans and a brain MRI at approximately 32 weeks. In cases with US and/or MRI abnormalities compatible with congenital CMV infection, AC was performed to confirm the diagnosis. RESULTS: Ninety pregnant women with a primary CMV infection were included (89 singleton and one twin pregnancy). The first-line screening by US and/or MRI was normal for 72 of 91 fetuses (79%). At birth, 19 of these 72 neonates (26%) had a positive urine sample for CMV but were asymptomatic. US and/or MRI abnormalities were identified in 19 fetuses (21%). AC confirmed a fetal CMV infection in 16 fetuses (84%); 12 pregnancies were terminated, and four were continued, with three symptomatic neonates at birth and one poor neurodevelopmental outcome at postnatal follow-up. CONCLUSIONS: First-line noninvasive management of maternal CMV primary infection based on serial US scans and brain MRI can be offered to identify fetuses with severe symptomatic congenital CMV infection and reduce the number of ACs without compromising the fetal outcome.

Disciplines :

Reproductive medicine (gynecology, andrology, obstetrics)

Author, co-author :

Denef, Marie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

NOEL, Laure ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

Bruck, Gaëlle; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

Gudelj, Justine ; Centre Hospitalier Universitaire de Liège - CHU > > Pool ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

Tebache, Malek; Service de Radiologie, CHR Liege, Liege, Belgium.

Viellevoye, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR)

Nisolle, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

Chantraine, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de

Language :

English

Title :

First-line noninvasive management of cytomegalovirus primary infection in pregnancy.

Publication date :

28 March 2022

Journal title :

Journal of Perinatal Medicine

ISSN :

0300-5577

eISSN :

1619-3997

Publisher :

Walter de Gruyter, United States - Delaware

Volume :

Issue :

Pages :

270-276

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 19 January 2023

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