Regression of fetal cerebral abnormalities by primary cytomegalovirus infection following hyperimmunoglobulin therapy.
OBJECTIVE
To assess the effects of maternal and intra-amniotic hyperimmunoglobulin (HIG) infusions among cytomegalovirus (CMV) infected fetuses with ultrasound abnormalities following a primary CMV infection.


METHODS
The subjects were fetuses with CMV-associated cerebral and other ultrasound abnormalities. Three mothers were treated with HIG infusions during pregnancy and two were untreated. Fetal ventricle size, organ echodensity and placental thickness were measured by ultrasound before and after HIG infusions. The children were evaluated between 3 and 7 years of age.


RESULTS
The ventriculomegaly of all three fetuses of HIG-treated mothers regressed and the ascites, hepatic echodensities, periventricular echodensities, and intestinal echodensities disappeared. Their sensorial, mental and motor development was normal at 4, 4.7, and 7 years of age. In contrast, both infants born of untreated mothers had signs and symptoms of severe CMV cerebropathy.


CONCLUSIONS
The outcomes of the infants born to HIG-treated mothers support the efficacy of HIG as a treatment for CMV-infected fetuses with ultrasound cerebral abnormalities.
Pediatric Department, University of L'Aquila, L'Aquila, Italy. nigrogio@libero.it
Giovanni
G
Nigro
Renato
R
La Torre
Henny
H
Pentimalli
Paola
P
Taverna
Mario
M
Lituania
Begona Martinez
BM
de Tejada
Stuart P
SP
Adler
D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D007231:Infant, Newborn; D008297:Male; D009421:Nervous System Malformations / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology; D011247:Pregnancy; D012074:Remission Induction; D016216:Ultrasonography, Prenatal
D007136:Immunoglobulins; D007155:Immunologic Factors