title: Fetal cytomegalovirus infection.
abstract: Cytomegalovirus (CMV) congenital infection affects 0.7% of live births worldwide and is the leading cause of congenital neurological handicap of infectious origin. However, systematic screening for this infection has not been implemented in pregnancy or at birth in any country. This apparent paradox had been justified by persisting gaps in the knowledge of this congenital infection: uncertain epidemiological data, difficulty in the diagnosis of maternal infection, absence of validated prenatal prognostic markers, unavailability of an efficient vaccine and scarcity of data available on the treatment. However, in the last decade, new data have emerged towards better management of this congenital infection, including solid epidemiological data, good evidence for the accuracy of diagnosis of maternal CMV infection and good evidence for the feasibility of predicting the outcome of fetal infection by a combination of fetal imaging and fetal laboratory parameters. There is also some evidence that valaciclovir treatment of mothers carrying an infected fetus is feasible, safe and might be effective. This review provides an update on the evidence for diagnosis, prognosis and treatment of congenital infection in the antenatal period. These suggest a benefit to a proactive approach for prenatal congenital infections.
authors.affiliation: EA 73-28, Université Paris Descartes, Sorbonne Paris Cité, Paris, 75005, France; AP-HP, Hôpital Necker-E.M., Laboratoire de Microbiologie Clinique. Centre national de Réfèrence Cytomegalovirus- Laboratoire associé, Paris, 75015, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Leruez-Ville
authors.affiliation: EA 73-28, Université Paris Descartes, Sorbonne Paris Cité, Paris, 75005, France; AP-HP, Hôpital Necker-E.M., Maternité, Unité de Médecine Fœtale, Paris, 75015, France. Electronic address: ville.yves@gmail.com.
authors.forename: Yves
authors.initials: Y
authors.lastname: Ville
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000653:Amniotic Fluid / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000175:diagnosis* / Q000188:drug therapy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000209:etiology; D007116:Immunization, Passive; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D054082:Lissencephaly / Q000000981:diagnostic imaging / Q000209:etiology; D008831:Microcephaly / Q000000981:diagnostic imaging / Q000209:etiology; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000209:etiology; D006831:Polyhydramnios / Q000000981:diagnostic imaging / Q000209:etiology; D065708:Porencephaly / Q000000981:diagnostic imaging / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D000069078:Seroconversion; D016216:Ultrasonography, Prenatal; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir
keywords: cytomegalovirus; fetus; hyperimmune globulin; imaging; serology; valaciclovir