title: Maternal IgG avidity, IgM and ultrasound abnormalities: combined method to detect congenital cytomegalovirus infection with sequelae.
abstract: OBJECTIVE
  We used maternal immunoglobulin M (IgM), immunoglobulin G (IgG) avidity index (AI) and fetal ultrasonography (US) to effectively detect a congenital cytomegalovirus-infected fetus that would suffer neurological sequelae after birth.
  
  
  METHODS
  The detecting method was prospectively adapted to 1163 unselected pregnant women. IgM, IgG and IgG-AI were measured at the first prenatal examination (10.8±2.2 weeks of gestation). Advanced US was performed for the IgM-positive women at our center. The urine of 1163 neonates was examined via PCR. All infected neonates were followed for neurological development.
  
  
  RESULTS
  Most women (83.3%) were seropositive. Among them, 40 (4.1%) were IgM positive. Nine of forty (22.5%) had low AI, of which one showed abnormal US and suffered severe sequelae. The remaining eight had a normal US; however, one infant had hearing impairment. There were another three infected infants with normal development. Their mothers' serological results were: IgM positive with high AI (n=1); IgG positive; IgM negative with high AI (n=1); and both IgG and IgM negative (n=1).
  
  
  CONCLUSIONS
  This method enabled us to detect infected fetuses having severe sequelae. However, the problem remains of detecting infected fetuses that only have a hearing impairment.
authors.affiliation: Department of Obstetrics and Gynecology, University of Miyazaki, Miyazaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kaneko
authors.forename: H
authors.initials: H
authors.lastname: Sameshima
authors.forename: T
authors.initials: T
authors.lastname: Minematsu
authors.forename: K
authors.initials: K
authors.lastname: Kusumoto
authors.forename: A
authors.initials: A
authors.lastname: Yamauchi
authors.forename: T
authors.initials: T
authors.lastname: Ikenoue
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M