J Korean Soc Matern Child Health.  2021 Apr;25(2):142-151. 10.21896/jksmch.2021.25.2.142.

Congenital Cytomegalovirus Infection in Pregnancy: A Case Report with Sequential Fetal Brain Changes and the Latest Information on Diagnosis, Treatment and Prevention

Affiliations
  • 1Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital, Goyang, Korea

Abstract

Congenital cytomegalovirus (CMV) infection is the most common nongenetic cause of sensorineural hearing loss and a major cause of visual, intellectual, and neurodevelopmental impairment worldwide. The seroprevalence of CMV among women of childbearing age in developing countries reaches almost 100%, and the incidence of CMV infection in neonates is 1%–2%. Approximately 87% of the infected neonates are asymptomatic at birth and 13% of them have permanent sequelae. The burden of congenital malformations due to congenital CMV infection is higher than that due to Down syndrome, fetal alcohol syndrome, and spina bifida. Nevertheless, there is little knowledge regarding congenital CMV pathogenesis, diagnosis, treatment, and prevention. In this study, we report a case that showed sequential changes of fetal brain following CMV infection in pregnancy. Additionally, we reviewed the latest information on the diagnosis, treatment, and prevention of congenital CMV infection.

Keyword

Cytomegalovirus, Congenital CMV infection, Prevention of CMV infection

Figure

  • Fig. 1. Ultrasound image showing mild dilatation of the left lateral ventricle (10.4 mm) with a dangling choroid plexus at 20 weeks 4 days of gestation.

  • Fig. 2. Mildly increased echogenicity of the fetal bowel with mild ascites on ultrasonography at 20 weeks 4 days of gestation.

  • Fig. 3. Newly developing multiple echogenic foci in fetal brain in ultrasound image (arrows) at 22 weeks 4 days of gestation.

  • Fig. 4. Proposed management of congenital cytomegalovirus (CMV) infection. MRI, magnetic resonance imaging. Modified from ISUOG Practice Guidelines: role of ultrasound in congenital infection. Ultrasound Obstet Gynecol 2020;56:128–51.


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