title: Congenital cytomegalovirus infection following antenatal negative diagnostic amniotic fluid analysis - a single center experience.
abstract: OBJECTIVE
  To determine the perinatal outcome of confirmed congenital cytomegalovirus (CMV) infection despite a negative prenatal amniotic-fluid analysis.
  
  
  METHODS
  A retrospective cohort study of all neonates diagnosed with congenital CMV infection from January 2006 to December 2011 despite negative results on polymerase chain reaction and shell's vial assays of amniotic fluid. Data were collected on all neonates by physical examination, blood work-up (complete blood count, bilirubin, liver enzymes), fundoscopy, brainstem evoked response (BSER), and brain ultrasound, at birth and during follow-up in the neonatal period.
  
  
  RESULTS
  The study group included 10 patients with primary congenital CMV infection during pregnancy. Follow-up time ranged from 1 to 62 months (median, 17 months). Four patients had consistently normal findings throughout follow-up, and three developed mild hepatosplenomegaly (1-32 months). In the remaining four offspring, brain ultrasound preformed after birth revealed lenticular striated vasculopathy (LSV) and in three of them the BSER test showed decreased hearing ability. Treatment with ganciclovir/valganciclovir was administered at age of 2 weeks, 2, 18, and 32 months. The BSER normalized after 9 and 12 months of treatment in two patients for whom follow-up data were available.
  
  
  CONCLUSIONS
  Negative findings on amniotic-fluid tests for CMV do not rule out neonatal infection with clinical morbidity.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center Beilinson Campus, Petah Tiqwa, Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Ben Ziv
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.forename: Joseph
authors.initials: J
authors.lastname: Pardo
mesh_terms: D000649:Amniocentesis / Q000706:statistics & numerical data*; D000653:Amniotic Fluid / Q000821:virology*; D002675:Child, Preschool; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology*; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000821:virology; D012189:Retrospective Studies