Τίτλος:
Prenatal diagnosis of fetal primary cytomegalovirus infection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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 (33.3%) had evidence of vertical
transmission. Nine out of 14 (64.3%) had positive amniotic fluid
culture, while 11 (78.6%) had positive polymerase chain reaction
results. The combination of both tests allowed antenatal diagnosis in 12
of the 14 infected fetuses (sensitivity 85.7%). 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.
Συγγραφείς:
Antsaklis, AJ
Daskalakis, GJ
Mesogitis, SA
Koutra, PT and
Michalas, SS
Περιοδικό:
British Journal of Obstetrics and Gynaecology
Εκδότης:
Blackwell Science Ltd Oxford, UK
DOI:
10.1111/j.1471-0528.2000.tb11583.x
