CMV

Question 1

Define CMV in pregnancy.

Answer 1

Common infection in pregnancy associated with severe congenital syndrome in the fetus.

Question 2

What is the aetiology of CMV in pregnancy?

Answer 2

Transmission: Sexual, blood, saliva, urine, vertical.

Question 3

What are the risk factors for CMV in pregnancy?

Answer 3

Higher SES

Immunosuppresson (HIV)

Question 4

Summarise the epidemiology for CMV in pregnancy.

Answer 4

50% immunity in pregnant women. 1% seronegative pregnant women will contract it.

Question 5

What are the symptoms of CMV in pregnancy?

Answer 5

Often asymptomatic

?Fever, malaise, fatigue

Question 6

What are the signs of CMV in pregnancy.

Answer 6

No clinical signs, lymphadenopathy.

Question 7

What investigations are performed for CMV in pregnancy?

Answer 7

Blood: CMV IgM (current)/IgG (past infection)

USS: Fetal anomaly scan

Other: Amniocentesis for CMV PCR (6-9wk after primary infection)

Question 8

What is the management for CMV in pregnancy?

Answer 8

No treatment to prevent transmission to fetus.

May offer termination of pregnancy if evidence of neural damage.

Neonatal ganacyclovir can attenuate hearing impairment.

Question 9

What are the complications associated with CMV in pregnancy? What is the prognosis of CMV in pregnancy?

Answer 9

High risk of miscarriage, stilbirth, congenital CMV, IUGR, microcephaly, intracerebral calcification, blind, sensorineural deafness, hepatosplenomegaly, skin rash, pneumonitis, mental retardation.

40% rate of transmission to fetus if infected mother. Of these, 10% develop fetal CMV syndrome. 90% of children with this develop neurological development delay.