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Diagnosis and antenatal management of congenital cytomegalovirus infection.

Publication ,  Journal Article
Society for Maternal-Fetal Medicine (SMFM); Hughes, BL; Gyamfi-Bannerman, C
Published in: Am J Obstet Gynecol
June 2016

Congenital cytomegalovirus (CMV) is the most common viral infection, affecting nearly 40,000 infants each year in the United States. Of seronegative women, 1-4% will acquire a primary infection during pregnancy, and the majority of these women will be asymptomatic. Prior maternal exposure to CMV does not preclude neonatal infection. The purpose of this document is to review diagnosis of primary maternal CMV infection, diagnosis of fetal CMV infection, and whether antenatal therapy is warranted. We recommend the following: (1) that women with a diagnosis of primary CMV infection in pregnancy be advised that the risk of congenital infection is 30-50%, on average, and that the severity of infection varies widely (Best Practice); (2) for women suspected of having primary CMV infection in pregnancy, we recommend that diagnosis should be either by IgG seroconversion or with positive CMV IgM, positive IgG, and low IgG avidity (grade 1B); (3) amniocentesis is the best option as a prenatal diagnostic tool to detect fetal congenital CMV infection, performed >21 weeks of gestation and >6 weeks from maternal infection (grade 1C); (4) we do not recommend routine screening of all pregnant women for evidence of primary CMV infection at this time (grade 1B); and (5) we do not recommend antenatal treatment with ganciclovir or valacyclovir; and we recommend that any antenatal therapy, either with antivirals or CMV hyperimmune globulin, should only be offered as part of a research protocol (Best Practice).

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Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

June 2016

Volume

214

Issue

6

Start / End Page

B5 / B11

Location

United States

Related Subject Headings

  • Ultrasonography, Prenatal
  • Prenatal Diagnosis
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Magnetic Resonance Imaging
  • Infectious Disease Transmission, Vertical
  • Infant, Newborn
  • Immunoglobulins, Intravenous
  • Immunoglobulins
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Society for Maternal-Fetal Medicine (SMFM), Hughes, B. L., & Gyamfi-Bannerman, C. (2016). Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol, 214(6), B5–B11. https://doi.org/10.1016/j.ajog.2016.02.042
Society for Maternal-Fetal Medicine (SMFM), Brenna L. Hughes, and Cynthia Gyamfi-Bannerman. “Diagnosis and antenatal management of congenital cytomegalovirus infection.Am J Obstet Gynecol 214, no. 6 (June 2016): B5–11. https://doi.org/10.1016/j.ajog.2016.02.042.
Society for Maternal-Fetal Medicine (SMFM), Hughes BL, Gyamfi-Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol. 2016 Jun;214(6):B5–11.
Society for Maternal-Fetal Medicine (SMFM), et al. “Diagnosis and antenatal management of congenital cytomegalovirus infection.Am J Obstet Gynecol, vol. 214, no. 6, June 2016, pp. B5–11. Pubmed, doi:10.1016/j.ajog.2016.02.042.
Society for Maternal-Fetal Medicine (SMFM), Hughes BL, Gyamfi-Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol. 2016 Jun;214(6):B5–B11.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

June 2016

Volume

214

Issue

6

Start / End Page

B5 / B11

Location

United States

Related Subject Headings

  • Ultrasonography, Prenatal
  • Prenatal Diagnosis
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Magnetic Resonance Imaging
  • Infectious Disease Transmission, Vertical
  • Infant, Newborn
  • Immunoglobulins, Intravenous
  • Immunoglobulins