CMV infection in Pregnancy

Question 1

Primary infection is associated with _____(high/low) fetal risk

Answer 1

High

Question 2

Recurrent infection is associated with _____(high/low) fetal risk

Answer 2

Low

Question 3

What is the leading congenital infection worldwide?

Answer 3

CMV infection

Question 4

What is the number one cause of hearing deficits in children?

Answer 4

neonatal CMV infection

Question 5

What percentage of pregnant women are seropositive for CMV?

Answer 5

50 - 80%

Question 6

What is the incubation period for CMV Infection?

Answer 6

40 Days

Question 7

What are the symptoms associated with CMV?

Answer 7

mild malaise, low grade fever, lymphadenopathy, hepatosplenomegaly

Question 8

What are the severe complications of CMV and what patients are at risk?

Answer 8

Chorioretinitis, pneumonitis in Immunocompromised patients

Question 9

How is CMV spread horizontally?

Answer 9

Mostly through saliva and urine, can also get it through sexual contact, blood transfusion, organ donation

Question 10

How is CMV transmitted vertically?

Answer 10

Transplacental, Perinatal, Breast-feeding

Question 11

What type of vertical transmission carries the highest risk to the fetus?

Answer 11

Transplacental, first trimester

Question 12

What is the most sensitive test for identifying acute CMV infection?

Answer 12

IgG avidity index

Question 13

What IgG avidity index signifies active infection?

Answer 13

avidity low or moderate

Question 14

CMV DNA PCR ____(can/cannot) differentiate from acute infection OR reactivation/new infection

Answer 14

Cannot

Question 15

What is the vertical transmission rate for primary CMV infection?

Answer 15

40%

Question 16

What percentage of neonatal CMV infections will have neurological sequalae?

Answer 16

10 - 20%

Question 17

When is the rate of transmission of CMV lowest but carries the highest risk to the fetus?

Answer 17

First trimester

Question 18

When is the rate of transmission of CMV the highest but carries the lowest risk to the fetus?

Answer 18

Third trimester

Question 19

There is a very ____(low/high) risk of vertical transmission in recurrent CMV infections

Answer 19

Low

Question 20

What is the most common cause of recurrent CMV infections?

Answer 20

Re-activation

Question 21

What are common cerebral findings in a fetus affected by CMV?

Answer 21

Microcephaly, ventriculomegaly, calcifications

Question 22

What are common abdominal findings in a fetus affected by CMV?

Answer 22

Liver and bowel calcifications, meconium peritonitis, ascites, pleural effusions

Question 23

What are common placental findings in a fetus affected by CMV?

Answer 23

placental insufficiency, IUGR

Question 24

How do you diagnose fetal CMV?

Answer 24

Amniocentesis

Question 25

What are the criteria for diagnosis CMV by Amnio?

Answer 25

Must be > 7 weeks following suspected maternal infection, > 21 wga

Question 26

What percentage of fetuses will be infected in mothers with acute infection?

Answer 26

40%

Question 27

What percentages of fetuses that will be infected with CMV will show signs of disease?

Answer 27

15 - 30%

Question 28

Acute CMV carries what risk of severe fetal effects?

Answer 28

6-12%

Question 29

Is there an effective treatment for CMV?

Answer 29

No treatment

Question 30

What are the most common newborn findings of CMV infection?

Answer 30

Thrombocytopenia, hepatosplenomegaly, petechiae, intracranial calcifications, jaundice, microcephaly

Question 31

What are more rare newborn findings of CMV infection?

Answer 31

chorioretinitis, sensorineural hearing loss