CMV infection in Pregnancy Flashcards
Primary infection is associated with _____(high/low) fetal risk
High
Recurrent infection is associated with _____(high/low) fetal risk
Low
What is the leading congenital infection worldwide?
CMV infection
What is the number one cause of hearing deficits in children?
neonatal CMV infection
What percentage of pregnant women are seropositive for CMV?
50 - 80%
What is the incubation period for CMV Infection?
40 Days
What are the symptoms associated with CMV?
mild malaise, low grade fever, lymphadenopathy, hepatosplenomegaly
What are the severe complications of CMV and what patients are at risk?
Chorioretinitis, pneumonitis in Immunocompromised patients
How is CMV spread horizontally?
Mostly through saliva and urine, can also get it through sexual contact, blood transfusion, organ donation
How is CMV transmitted vertically?
Transplacental, Perinatal, Breast-feeding
What type of vertical transmission carries the highest risk to the fetus?
Transplacental, first trimester
What is the most sensitive test for identifying acute CMV infection?
IgG avidity index
What IgG avidity index signifies active infection?
avidity low or moderate
CMV DNA PCR ____(can/cannot) differentiate from acute infection OR reactivation/new infection
Cannot
What is the vertical transmission rate for primary CMV infection?
40%
What percentage of neonatal CMV infections will have neurological sequalae?
10 - 20%
When is the rate of transmission of CMV lowest but carries the highest risk to the fetus?
First trimester
When is the rate of transmission of CMV the highest but carries the lowest risk to the fetus?
Third trimester
There is a very ____(low/high) risk of vertical transmission in recurrent CMV infections
Low
What is the most common cause of recurrent CMV infections?
Re-activation
What are common cerebral findings in a fetus affected by CMV?
Microcephaly, ventriculomegaly, calcifications
What are common abdominal findings in a fetus affected by CMV?
Liver and bowel calcifications, meconium peritonitis, ascites, pleural effusions
What are common placental findings in a fetus affected by CMV?
placental insufficiency, IUGR
How do you diagnose fetal CMV?
Amniocentesis
What are the criteria for diagnosis CMV by Amnio?
Must be > 7 weeks following suspected maternal infection, > 21 wga
What percentage of fetuses will be infected in mothers with acute infection?
40%
What percentages of fetuses that will be infected with CMV will show signs of disease?
15 - 30%
Acute CMV carries what risk of severe fetal effects?
6-12%
Is there an effective treatment for CMV?
No treatment
What are the most common newborn findings of CMV infection?
Thrombocytopenia, hepatosplenomegaly, petechiae, intracranial calcifications, jaundice, microcephaly
What are more rare newborn findings of CMV infection?
chorioretinitis, sensorineural hearing loss
