The obstetrician, congenital cytomegalovirus, clinical and diagnostic approaches to the pregnant woman
Antonia W Shand
+ Author Affiliations
- Author Affiliations
Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
Sydney Medical School Northern, University of Sydney, Australia
Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, NSW 2031, Australia
Tel: +61 2 9382 6098
Fax: +61 2 9382 6038
Email: Antonia.shand@sydney.edu.au
Microbiology Australia 36(4) 194-196 https://doi.org/10.1071/MA15067
Published: 23 October 2015
Abstract
There is low awareness of congenital cytomegalovirus (CMV) in Australia. Routine pregnancy serological screening for CMV is not recommended, but all pregnant women should be given advice about CMV prevention. Obstetricians may be asked to see a pregnant woman when serology suggests CMV infection or when features of fetal infection are present on ultrasound. If maternal CMV infection is confirmed, the timing of infection (pre-pregnancy or gestation of pregnancy), must be determined to predict the fetal risks. In addition, it is important to establish whether maternal infection is primary or reactivation. If there is fetal infection, ultrasound can be used to attempt to establish whether the fetus may have been affected. Serial serology, CMV IgG avidity, maternal viraemia (using serum PCR), amniotic fluid CMV PCR, serial fetal ultrasounds, and possibly fetal MRI (magnetic resonance imaging) are investigations that may be useful to predict neonatal outcomes. Timely and accurate counselling is important to optimise maternal and neonatal management.
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