M Enders1, A Daiminger1, S Exler1, K Ertan2, G Enders1, R Bald2. 1. Laboratory Prof. Gisela Enders & Colleagues MVZ and Institute of Virology, Infectiology and Epidemiology e.V., Stuttgart, Germany. 2. Department of Obstetrics, Gynecology and Prenatal Medicine, Klinikum Leverkusen, Leverkusen, Germany.
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.
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.
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561
Authors: Mara J Dinsmoor; Lida M Fette; Brenna L Hughes; Dwight J Rouse; George R Saade; Uma M Reddy; Donna Allard; Gail Mallett; Elizabeth A Thom; Cynthia Gyamfi-Bannerman; Michael W Varner; William H Goodnight; Alan T N Tita; Maged M Costantine; Geeta K Swamy; Kent D Heyborne; Edward K Chien; Suneet P Chauhan; Yasser Y El-Sayed; Brian M Casey; Samuel Parry; Hyagriv N Simhan; Peter G Napolitano; George A Macones Journal: Am J Obstet Gynecol MFM Date: 2022-05-06
Authors: Bettie Voordouw; Barry Rockx; Thomas Jaenisch; Pieter Fraaij; Philippe Mayaud; Ann Vossen; Marion Koopmans Journal: Clin Microbiol Rev Date: 2019-12-11 Impact factor: 26.132