Cytomegaly in pregnant women often does not give any obvious symptoms, but it is particularly dangerous in this period, as it may cause malformations in the development of the fetus and even lead to its death. Therefore, it is important to know what consequences may be associated with cytomegalovirus (CMV) infection in pregnant women.

Cytomegaly does not pose a threat to the mother-to-be. Infection is asymptomatic in90%of pregnant women and is usually not detected. However, it is a huge threat to the fetus. CMV is the main cause of non-genetic hearing loss and an important factor in CNS damage leading to psychomotor and mental retardation in children.

Cytomegaly - sources of infection

Cytomegalovirus infection of the fetus occurs:

  • byplacenta- the risk of virus transmission through the placenta increases with the duration of pregnancy, and the clinical consequences for the fetus are most severe in the first half of pregnancy;
  • duringchildbirth .

Factors increasing the risk of CMV infection are the lack of specific IgG antibodies in pregnancy, the mother's age under 20 and frequent contact with young children during pregnancy1 . In addition, it is also believed that pregnancy may increase the sensitivity of pregnant women to virus infection and the activation of previously inactive forms.

Cytomegaly is the most common viral congenital infection. It is estimated that it affects0.5-2%newborns.

Cytomegaly in pregnancy - symptoms

U85-90 percentof newborns infection is asymptomatic. Only 5-10 percent. of them, symptoms of congenital cytomegalovirus are observed1,2 , such as:

  • hypotrophy (weight loss in relation to pregnancy age);
  • microcephaly;
  • enlargement of the liver and spleen (hepatosplenomegaly) with hepatitis;
  • intracranial calcifications (in 1% of children);
  • hydrocephalus;
  • jaundice;
  • symptoms of hemorrhagic diathesis with petechiae and bloody streaks.

The most common symptoms also include mild mental retardation.

The neurological examination also states:

  • disturbances in the distribution of muscle tension (increased muscle tension, hypotonia)
  • convulsions

Laboratory test deviations include:

  • anemia,
  • neutropenia,
  • thrombocytopenia.

The ophthalmological examination states:

  • choroiditis or optic nerve atrophy;
  • cataracts and small eyes (relatively rare)

The audiological examination (ABR) shows neurosensory hearing loss. Cytomegaloviral hearing impairment occurs35‒60%children with symptomatic infection; it may reveal itself immediately after birth or at a later stage.

It should be emphasized that the presence of specific IgG antibodies before or at the beginning of pregnancy does not exclude fetal infection, while fetal infection does not always lead to symptomatic disease and its late consequences.

Cytomegaly in pregnancy - dangerous consequences

In pregnant women, cytomegaly isasymptomatico, which is why it is so difficult to recognize it. Unfortunately, infection at this time can be dangerous for the offspring. The consequences depend on at what point in the pregnancy you became infected.

If the infection took place in1st trimester , there is a very high risk:

  • miscarriages;
  • development of a serious birth defect in the nervous system.

Infection inII or III trimestermay be associated with:

  • brain damage (manifested by developmental disorders, epilepsy);
  • premature labor.

Children of mothers infected with CMV during pregnancy usually have he alth problems from birth. They are diagnosed with congenital cytomegalovirus syndrome with symptoms such as:

  • enlargement of the spleen and liver;
  • jaundice;
  • bruises;
  • pneumonia.

Sometimes the cytomegalovirus initially remains dormant and manifests itself even with a delay of several years, resulting in e.g.

  • total hearing loss;
  • visual disturbance;
  • mental retardation.

Cytomegaly in pregnancy - diagnosis

Currently, there is no routine diagnosis of pregnant women for cytomegalovirus infection in Poland1 , however obstetricians more and more often recommend specific serological tests.

It is also impossible to protect yourself from the ubiquitous virus. Some doctors recommend testing for this condition for women planning pregnancy. However, these are not standard tests. Tests are performed with blood and zurine. The blood level is assessed for the level ofIgG and IgM antibodiesanti-cytomegaly - the so-calledserology . The presence of IgM antibodies and a significant increase in IgG antibodies indicate the existence of primary infection1 . If these are found in the blood several months before pregnancy, the woman has had cytomegalovirus, and the antibodies in her body are protecting her from fresh infection. It is comforting that over 80 percent. women of childbearing age have the presence of IgG antibodies2 , which proves that these women have come into contact with cytomegalovirus before and do not suffer from primary infection during pregnancy.

Cytomegaly in pregnancy - how is it treated?

When an active CMV infection is diagnosed in a future mother, there is no generally recognized treatment to prevent vertical transmission of the infection or to treat a symptomatic fetus. A newborn of a mother suspected of being infected with cytomegalovirus in the prenatal period should be referred to a specialist center for diagnosis, possible treatment and specialist care.

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Pregnant examinations