Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases: a 5 years' single center experience. (16th March 2017)

• Record Type: Journal Article
• Authors: Enders, M.; Daiminger, A.; Exler, S.; Ertan, K.; Enders, G.; Bald, R.
• Is Part Of: Prenatal diagnosis. Volume 37:Number 4(2017)
• Page Start: 389
• Page End: 398
• Publication Date: 2017-03-16
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.5025
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Objective: The objective of this study is to investigate the diagnostic value of invasive prenatal diagnosis (PD) of congenital cytomegalovirus (CMV) infection from amniotic fluid (AF) and fetal blood (FB). Methods: A retrospective study was conducted on 115 pregnancies with CMV primary infection. A total of 111 AF and 106 FB samples were investigated for various virological and non‐virological markers. Detailed ultrasound examinations were performed at time of PD. Results: Overall sensitivity of CMV PCR in FB (75.6%; 95%CI 60–87) and AF (72.7%; 95%CI 57–85) was comparable. In women with amniocentesis >8 weeks between seroconversion and PD, we did not observe significant differences between amniocentesis performed ≥17 + 0 (sensitivity 90.9%; 95%CI 71–99) and ≥20 + 0 gestational weeks (sensitivity 90.0%; 95%CI 68–99). Virological markers in FB were higher in symptomatic compared with asymptomatic fetuses ( p < 0.05). No significant differences were observed for non‐virological markers. However, platelet counts <120 × 10e9/L and beta‐2 microglobulin values >14 mg/L were more frequently found in fetuses with severe ultrasound abnormalities compared with fetuses with no or mild abnormalities ( p < 0.001). Conclusion: Optimal timing of amniocentesis in women with primary infection in early gestation should be reevaluated in a prospective study. Analysis of FB markers may be beneficial in the individual management of pregnant women with confirmed congenital CMV infection. © 2017 John Wiley & Sons, Ltd. Abstract : What's already known about this topic? According to current recommendations, amniocentesis should be performed after gestational week 21 and >6 to 8 weeks after maternal cytomegalovirus seroconversion. The role of virological and non‐virological fetal blood markers as indicators of the severity of congenital disease is under investigation. What does this study add? Sensitivity of amniocentesis at 17 + 0 to 19 + 6 gestational weeks should be reevaluated in a prospective study. Analysis of FB markers may be helpful in individual management of pregnancies with confirmed fetal infection.