What is the epidemiology of CMV?
What are the fetal risks from primary maternal CMV infection in pregnancy?
What are the fetal risks from recurrent maternal CMV infection?
How is primary maternal CMV infection diagnosed?
|Ultrasound finding||Frequency, %|
|Fetal growth restriction||1.9–13|
|Placentomegaly or placental calcifications||4.3|
How is a diagnosis of fetal CMV infection made?
What is the role of imaging in assessing fetal infection?
Is universal screening for CMV infection recommended?
What therapies are recommended for CMV infection?
- Kimberlin D.W.
- Lin C.Y.
- Sánchez P.J.
- et al.
Is it possible to prevent maternal primary CMV infection?
|1.||Women with primary CMV in pregnancy have a risk of congenital infection of 30-50% and the severity of infection varies widely.||Best Practice|
|2.||For women suspected of having primary CMV infection in pregnancy, we recommend that diagnosis should be either by IgG seroconversion or with positive CMV IgM, positive IgG, and low IgG avidity.||1B|
Strong recommendation, moderate-quality evidence
|3.||Amniocentesis is the best option as a prenatal diagnostic tool to detect fetal congenital CMV infection, performed >21 weeks of gestation and >6 weeks from maternal infection.||1C|
Strong recommendation, low-quality evidence
|4.||We do not recommend routine screening of all pregnant women for evidence of primary CMV infection at this time.||1B|
Strong recommendation, moderate-quality evidence
|5.||We do not recommend antenatal treatment with ganciclovir or valacyclovir; and we recommend that any antenatal therapy, either with antivirals or CMV hyperimmune globulin, should only be offered as part of a research protocol.||Best Practice|
|American Congress of Obstetricians and Gynecologists||Practice bulletin no. 151: Cytomegalovirus (CMV), parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy||2015|
|Society of Obstetricians and Gynaecologists of Canada||Clinical practice guideline: CMV infection in pregnancy||2010|
|Centers for Disease Control and Prevention||CMV and congenital CMV infection: clinical diagnosis and treatment||2010|
|Royal College of Obstetricians and Gynaecologists||Review: Primary and secondary CMV in pregnancy||2009|
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Centers for Disease Control and Prevention. Cytomegalovirus (CMV) and congenital CMV infection: clinical diagnosis and treatment. Available at: http://www.cdc.gov/cmv/clinical/diagnosis-treatment.html. Retrieved Nov. 5, 2015.
A listing of articles in this series that were published in other journals before #36 appeared in the June 2015 issue of AJOG is available at smfm.org/publications/.
All authors and Committee members have filed a conflict of interest disclosure delineating personal, professional, and/or business interests that might be perceived as a real or potential conflict of interest in relation to this publication. Any conflicts have been resolved through a process approved by the Executive Board. The Society for Maternal-Fetal Medicine has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
This document has undergone an internal peer review through a multilevel committee process within the Society for Maternal Fetal Medicine (SMFM). This review involves critique and feedback from the SMFM Publications and Risk Management Committees and final approval by the SMFM Executive Committee. SMFM accepts sole responsibility for document content. SMFM publications do not undergo editorial and peer review by the American Journal of Obstetrics & Gynecology. The SMFM Publications Committee reviews publications every 18-24 months and issues updates as needed. Further details regarding SMFM Publications can be found at www.smfm.org/publications. All questions or comments regarding the document should be referred to the SMFM Publications committee at [email protected] .