American Journal of Obstetrics

and Gynecology Founded in 1920

volume 163

number 2

AUGUST

1990

CLINICAL SECTION Clinical Opinion

Prenatal diagnosis of congenital cytomegalovirus infection: Two decades later Charles Grose, MD, and Carl P. Weiner, MD Iowa City, Iowa Cytomegalovirus is the most common cause of congenital infection in the United States, yet there has been little progress in the prenatal diagnosis of this intrauterine infection. We present evidence that viral culture of amniotic fluid may be a useful adjunct procedure, when performed as part of the antenatal evaluation of suspected fetal cytomegalovirus infection. (AM J OBSTET GVNECOL 1990;163:447-50.)

Key words: Cytomegalovirus, prenatal diagnosis, congenital infection Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 30,000 to 40,000 liveborn infants annually in the United States.1.2 However, prenatal diagnosis of fetal CMV infection has received little attention over the last 20 years and was not mentioned in a recent editorial strongly urging renewed efforts to eliminate the problem.' In this Clinical Opinion, we briefly survey the epidemiologic characteristics of congenital CMV infection. Then we review published methods of prenatal diagnosis and provide evidence for our opinion that viral cultures of amniotic fluid may be a useful procedure. Finally, we suggest that antenatal diagnosis can play an important role in suggested programs that seek to prevent congenital infection and to treat those cases that do occur. CMV is one of the human herpesviruses, which also include herpes simplex virus types 1 and 2, varicellazoster virus, Epstein-Barr virus, and human herpesvirus type 6. Pregnant women usually acquire the initial CMV infection by exposure to body excretions (saliva, From the Departments of Pediatrics and Obstetrics and Gynecology, University of Iowa College of Medicine. Research by the authors was supported by grants from the National Institutes of Health. Reprint requests: Charles Grose, MD, Department of Pediatrics, University of Iowa Hospitals, Iowa City, IA 52242. 611121409

urine) of young children or by intimate sexual contact. I·' Women at greatest risk are those

Prenatal diagnosis of congenital cytomegalovirus infection: two decades later.

Cytomegalovirus is the most common cause of congenital infection in the United States, yet there has been little progress in the prenatal diagnosis of...
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