title: Intrauterine therapy with cytomegalovirus hyperimmunoglobulin for a fetus congenitally infected with cytomegalovirus.
abstract: Reported herein is a case of hydrops fetalis in which the cord blood expressed cytomegalovirus (CMV) antigen. Fetal ascites was removed from an infected fetus with hydrops in utero and 2.5 g CMV hyperimmunoglobulin was administered into the fetal abdominal cavity at 28 weeks gestation. After immunoglobulin administration, fetal ascites vanished, preload index of the inferior vena cava decreased and platelet count of the infant increased. However, despite intrauterine therapy and intensive neonatal care, the infant died soon after birth. The expression of CMV antigen in the nucleus of polymorphonuclear leukocytes in fetal cord blood indicated that the fetal hydrops was caused by CMV infection. When symptomatic CMV infection of a fetus is suspected from serological and ultrasound findings, further examinations should be performed for the diagnosis. Intrauterine immunoglobulin therapy could be one of the therapeutic options for the affected fetus.
authors.affiliation: Department of Gynecology and Obstetrics, Akita Kumiai General Hospital, Nishibukuro Iijima, Akita, Japan. akira.sa@themis.ocn.ne.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Hideto
authors.initials: H
authors.lastname: Hirano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miura
authors.forename: Naoko
authors.initials: N
authors.lastname: Hosoya
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogawa
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D046128:Fetal Therapies / Q000379:methods; D005333:Fetus; D006801:Humans; D015160:Hydrops Fetalis / Q000628:therapy*; D007136:Immunoglobulins / Q000008:administration & dosage*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*
chemical_list: D007136:Immunoglobulins