Prenatal diagnosis and pregnancy outcomes of fetal intrauterine human cytomegalovirus infection

LUO Ming-yue; LIN Hai-ying; SHEN Kai; YAN Ze-hao; MAI Guang-xing; LAN Hui-juan; XIONG Li-kuan

doi:10.13820/j.cnki.gdyx.20233992

Abstract：Objective To investigate the intrauterine infection rate of human cytomegalovirus(HCMV)in fetuses and analyze the ultrasound findings and pregnancy outcomes of fetuses with intrauterine HCMV infection from 2016 to 2021 at Shenzhen Baoan Woman's and Children's Hospital.Methods Amniotic fluid samples from 4 685 pregnant women who underwent amniocentesis at our hospital were tested for HCMV-DNA.A retrospective analysis was conducted on HCMV-IgG and IgM test results in a subset of cases.Chromosomal karyotyping,ultrasound examinations,and pregnancy out-comes were tracked for 11 cases with positive HCMV-DNA.Results Among the 4 685 amniotic fluid samples,4 674 were HCMV-DNA negative.Of 2 076 pregnant women,26 had positive serum HCMV-IgM,and among 1 482 tested,1 454 were positive for HCMV-IgG.For the 11 pregnant women with positive amniotic fluid HCMV-DNA,the following results were observed:serum HCMV-IgM positive in 3 cases and negative in 8 cases;HCMV-IgG positive in 8 cases,with 3 cases not tested;HCMV-DNA in urine was positive in 2 cases,negative in 7 cases,and not tested in 2 cases;se-rum HCMV-DNA was negative in 9 cases,with 2 cases not tested.Of the 11 cases with intrauterine HCMV infection,2 had positive HCMV-IgM before amniocentesis.The remaining 9 underwent amniocentesis due to abnormal fetal ultra-sound findings or high-risk Down syndrome screening.Ultrasound results related to HCMV infection were observed in 7 cases:6 resulted in termination,and 1 newborn was without abnormalities.Four cases showed no infection-related find-ings on ultrasound,and all had normal deliveries with no abnormalities detected postpartum.Conclusion Amniotic fluid HCMV-DNA testing provides accurate diagnosis of congenital CMV infection.Serum Ig and DNA tests in pregnant women have limited diagnostic value.Some fetuses with intrauterine HCMV infection may present ultrasound abnormali-ties,while others may be asymptomatic at birth.