title: Effective management and intrauterine treatment of congenital cytomegalovirus infection: review article and case series.
abstract: OBJECTIVE
  Human Cytomegalovirus (CMV) infection during pregnancy is the most frequent viral cause of intrauterine infection and responsible for various cerebral and other ultrasound abnormalities of the fetus. It is the leading infectious cause of mental retardation and sensorineural deafness in affected newborns and infants. We present three cases of primary cytomegalovirus infection in pregnancy and demonstrate three different scenarios of the disease with regard to clinical outcome and therapy options. We first report on CMV related phospho- and glycoprotein-specific antibody reactivities in amnion fluid that have not been reported earlier in literature.
  
  
  METHODS
  Case 1: A 33-year-old Gravida II Para I was referred for primary CMV infection at 15 weeks gestation presenting with a history of fever. HIG therapy was performed resulting in good neonatal outcome. Case 2: A 23-year-old Gravida I was referred for targeted ultrasound at 23 weeks of gestation presenting with intrauterine growth retardation, multiple fetal hepatic echodensities and thickened placenta. Termination of pregnancy was initiated. Case 3: A 29-year-old Gravida II Para I was referred for primary CMV infection at 16 weeks gestation presenting with no clinical symptoms of CMV. HIG therapy was performed, resulting in good neonatal outcome.
  
  
  CONCLUSIONS
  We want to stress the potential benefit of an off label use of CMV-specific hyperimmune globulin (HIG) therapy, present an algorithm for the management of affected pregnancies and review current literature on this issue.
authors.affiliation: Department of Obstetrics and Gynecology , Marienhospital Essen , Germany .
authors.forename: Norbert
authors.initials: N
authors.lastname: Wagner
authors.forename: Karl Oliver
authors.initials: KO
authors.lastname: Kagan
authors.forename: Susanne
authors.initials: S
authors.lastname: Haen
authors.forename: Sybille
authors.initials: S
authors.lastname: Schmidt
authors.forename: Gülen
authors.initials: G
authors.lastname: Yerlikaya
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Maden
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahn
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamprecht
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007136:Immunoglobulins / Q000008:administration & dosage*; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; C045781:cytomegalovirus-specific hyperimmune globulin