title: Congenital Cytomegalovirus Infection in the Absence of Maternal Cytomegalovirus-IgM Antibodies.
abstract: BACKGROUND
  Congenital cytomegalovirus (cCMV) infections are the most prevalent intrauterine infections worldwide and are the result of maternal primary or non-primary infections. Early maternal primary infections are thought to carry the highest risk of fetal developmental abnormalities as seen by ultrasound; however, non-primary infections may prove equally detrimental.
  
  
  RESULTS
  This case series presents 5 cases with fetal abnormalities detected in the second and third trimester, in which cCMV infection was ruled out due to negative maternal CMV-IgM.
  
  
  CONCLUSIONS
  This series highlights the possible pitfalls in serology interpretation and fetal diagnosis necessary for appropriate parental counseling. Once fetal abnormalities have been confirmed and cCMV is suspected, maternal CMV serostatus and fetal infection should be determined. Maternal CMV serology may be ambiguous; therefore, caution should be exercised when interpreting the results.
authors.affiliation: Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Julia
authors.initials: J
authors.lastname: Gunkel
authors.forename: Bloeme J
authors.initials: BJ
authors.lastname: van der Knoop
authors.forename: Joppe
authors.initials: J
authors.lastname: Nijman
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Gwendolyn T R
authors.initials: GTR
authors.lastname: Manten
authors.forename: Peter G J
authors.initials: PGJ
authors.lastname: Nikkels
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Murk
authors.forename: Johanna I P
authors.initials: JIP
authors.lastname: de Vries
authors.forename: Tom F W
authors.initials: TFW
authors.lastname: Wolfs
mesh_terms: D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000000981:diagnostic imaging* / Q000276:immunology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging* / Q000276:immunology; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D016216:Ultrasonography, Prenatal
chemical_list: D007075:Immunoglobulin M
keywords: Congenital infection; Cytomegalovirus; Fetal ultrasound abnormalities; Maternal non-primary infection; Maternal primary infection; Outcome