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    SMFM Consult: Diagnosis and antenatal management of CMV infection

    In utero exposure to this common pathogen can have serious consequences for some infants.

    By the Society for Maternal-Fetal Medicine (SMFM); Brenna L Hughes, MD, MSC; and Cynthia Gyamfi-Bannerman, MD, MSC

    Created in partnership with the Society for Maternal-Fetal Medicine. SMFM was established in 1977 to "give MFM physicians and scientists a place to share knoweldge, research and clinical best practices in order to improve care for moms and babies."

     

    This Maternal-Fetal Medicine (MFM) consult provides information regarding the diagnosis and antenatal management of congenital cytomegalovirus (CMV), the most common perinatal viral infection leading to neonatal and childhood sequelae, which affects nearly 40,000 infants each year in the United States. The purpose of this document is to review diagnosis of primary maternal and fetal CMV infection, and assess whether antenatal therapy is warranted. 

     

    For a patient handout on this topic, visit www.ContemporaryObGyn.net/cmv-infection

    Q. What is the epidemiology of CMV?

    A. CMV, a herpes virus, is the most common viral infection of the fetus and the leading nongenetic cause of congenital deafness, affecting nearly 40,000 infants each year in the United States. Fetal infection can result in a wide range of outcomes for children, from asymptomatic infection to severe disability and death.  Birth prevalence reflects all neonatal infections detected at birth as a result of both primary and recurrent infections.

    The prevalence of prior exposure in women of childbearing age varies by region and income and ranges from 40% to 83%.  Of the 1% to 4% of seronegative women who acquire a primary infection during pregnancy, the majority will be asymptomatic. Seroconversion varies by socioeconomic status, with 1.6% of women from middle- and high-income groups seroconverting during pregnancy, compared to 3.7% of women in low-income groups. Less commonly, women with a prior CMV infection may experience either re-infection with different strains or reactivation of disease. Although congenital infection can occur with reactivation or recurrent infection, it is far more likely in the setting of maternal primary infection.

    NEXT: Fetal risks

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    • Anonymous
      I cannot access the references for this article. I tried the link listed in the paper copy and I looked all over this site. Where are the references?

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