CMV in pregnancy

Question 1

What is CMV in pregnancy

Answer 1

CMV is a type of HHV- HHV5
usually latent infection in many people - in Monocytes
30% become congenital infections
and from those 90% are asympto, 10% have abnormalities

most common congenital infection

Sexual contact, blood, body fluids, vertical
RF- higher socioeconomic (no childhood immunity, immunosupression
50% of preg women are immune

Question 2

Sx of CMV in pregnancy (mum and child)

Answer 2

Mum - often asy,ptomatic with occasionaal lymphadenopathy
30-40% vertical transmission at any stage of preg

Child
90% asymtomatic at birth - 10% later develop sensorineural hearing loss

10% congenital CMV-
65% have SNHL, 
peri-ventricular calcification (unlike toxo-all over)
Chorioretinitis-cataracts
Jaudince + blueberry muffin rash
IGUR
Microcephaly, hepatospenomegaly

Question 3

Ix of CMV in pregnancy

Answer 3

PRentala- PCV of virs >21w GA
Post natal - PCR of virus <21d neonate -any result after this canot confirm Congenital CMV

Maternal serology - seroconversion IgM- to IgM + –but they can persist for month - not good enough
USS of foetis
amnioscitesis PCR -6-9w post primary infection

Question 4

Mx and complications of CMV in pregnancy

Answer 4

Mother - no treatment, but TOP if CNS damage
Child - gancuclovir, valganciclovir (oral) for 6m, audiology and ophtalmology follow up

complications -
misscarriage and still birth
Congenital CMV