Introduction: Guidelines for the management of cytomegalovirus (CMV) infection of the fetus are rare. Our main objective was to evaluate how health care practitioners in France manage cases of CMV seroconversion during pregnancy.
Material And Methods: A questionnaire was e-mailed to health care practitioners potentially concerned by CMV seroconversion during pregnancy. They were asked if they would recommend amniocentesis, fetal cerebral MRI examination and fetal blood analysis (FBA), depending on the ultrasound results. They then had to indicate whether they would accept termination of pregnancy (TOP), depending on the results of these examinations.
Results: A total of 380 health care practitioners responded, mainly obstetricians (73.9%) and midwives (20.2%). Overall, 57% of respondents recommended amniocentesis in the case of CMV seroconversion during the first trimester of pregnancy, ultrasound findings being normal. In cases of positive amniocentesis and a major ultrasound abnormality, 84.5% of respondents would perform cerebral MRI, and 44.4% would perform FBA. In this case, the rate of acceptance of TOP was not significantly different whether the examinations were normal (337/372, 90.6%) or not performed (339/374, 93.3%; p = 0.17).
Discussion: Amniocentesis is too infrequently used and should be encouraged. The results of MRI and FBA are often not taken into account in the final decision concerning TOP. Guidelines are needed to clarify the management of CMV seroconversion during pregnancy.
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http://dx.doi.org/10.1159/000381850 | DOI Listing |
Fetal Diagn Ther
October 2024
Division of Ultrasound in ObGyn at Lis Maternity and Women's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.
Eur Arch Otorhinolaryngol
October 2024
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario 12 Octubre, Avenida Córdoba S/N, 28041, Madrid, Spain.
Purpose: To search for existing evidence of prognostic factors related to the development of late-onset hearing loss (LOHL) in infants with congenital cytomegalovirus (cCMV).
Methods: A PRISMA systematic review was performed, with the PubMed, Embase, and Web of Science databases searched from inception through to December 2023; after the application of inclusion and exclusion criteria a total of 9 papers were included in this review. PROSPERO registration number CRD42024492244.
BMJ Paediatr Open
September 2024
Obstetrics and Gynecology, Fetal-Maternal Medicine, University Hospitals Leuven, Leuven, Belgium
Objective: To document the course of neonatal and short-term outcomes in pregnancies after first trimester CMV (cytomegalovirus) seroconversion and negative amniotic fluid (AF) CMV PCR.
Methods: We included 375 patients with a first-trimester CMV seroconversion and amniocentesis at ≥21 weeks. Termination of pregnancy (TOP) was offered in case antenatally severe CMV-related fetopathy was documented either by ultrasound or by MRI.
Clin Transplant
September 2024
Cardiothoracic Board, Freeman Hospital, Newcastle upon Tyne Hospital Trust, Newcastle upon Tyne, UK.
Purpose: The aim of the study was to determine outcomes after heart transplantation for cytomegalovirus (CMV) mismatched patients (D/R) who underwent a surveillance and preemptive therapy protocol, compared to nonmismatch patients.
Methods: A review of patient records from January 2010 to December 2020 with follow-up to October 2023 was done. The protocol consisted weekly surveillance with CMV PCR starting 4 weeks after transplant continuing up until the patient seroconverts or up to 3 months posttransplant if the patient does not seroconvert.
Open Forum Infect Dis
August 2024
Université Paris Cité, Biology of Emerging Viruses Team, INSERM U-944, F-75010 Paris, France.
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