Cytomegalovirus-associated acute hydramnios treated by amniocentesis and maternal indomethacin.
A 22-year-old pregnant woman noticed a rapid increase of abdominal growth, uterine tenderness and irregular contraction, for which she hospitalized at 25 weeks of gestation. An ultrasound examination demonstrated a single fetus with normal anatomy and massive hydramnios. Serial therapeutic amniocentesis was performed for relief of maternal symptoms and indomethacin compress was initiated. Both the maternal and amniotic fluid IgM were positive for cytomegalovirus (CMV). Maternal compress indomethacin was discontinued at 32 weeks. Cesarean section was performed due to fetal distress at 34 weeks of gestation. A female infant was delivered and the neonatal examination was within normal limits with urine culture positive for CMV. At 1 year of age the child was developing normally with normal hearing and no clinical sequelae of intrauterine CMV infection. We postulate that serial and large volume reduction of amniotic fluid by amniocentesis and compress indomethacin in our case interrupted the natural course and provided sufficient time for the fetus to recover from the acute phase of viral infection.
Suzumori
Nobuhiro
N
Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan. og.n.suz@med.nagoya-cu.ac.jp
Hattori
Yukio
Y
Kaneko
Saori
S
Suzuki
Yoshikatsu
Y
Sugiura-Ogasawara
Mayumi
M
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000188:drug therapy* / Q000635:transmission; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D006831:Polyhydramnios / Q000628:therapy*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011296:Prenatal Diagnosis; D016216:Ultrasonography, Prenatal; D055815:Young Adult
D007213:Indomethacin