[Cytomegalovirus infection in pregnancy: A fourteen-year review in a pluridisciplinary prenatal center].

Autor: Delay F; Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 93, boulevard Jean-Monnet, 44093 Nantes, France; Service de gynécologie-obstétrique, CHD de la Roche-sur-Yon, 85000 Roche-sur-Yon, France., Coste Burel M; Laboratoire de virologie, CHU de Nantes, Hôtel-Dieu, quai Moncousu, 44093 Nantes, France., Joubert M; Service d'anatomie et de cytologie pathologique, CHU de Nantes, Hôtel-Dieu, quai Moncousu, 44093 Nantes, France., Winer N; Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 93, boulevard Jean-Monnet, 44093 Nantes, France. Electronic address: norbert.winer@chu-nantes.fr.
Jazyk: francouzština
Zdroj: Journal de gynecologie, obstetrique et biologie de la reproduction [J Gynecol Obstet Biol Reprod (Paris)] 2016 Nov; Vol. 45 (9), pp. 1115-1126. Date of Electronic Publication: 2016 Feb 19.
DOI: 10.1016/j.jgyn.2015.12.012
Abstrakt: Background: Cytomegalovirus (CMV) is the most frequent cause of congenital infection. The aim of this research was to describe the decision-process for parents to pursue gestation or to ask medical abortion after materno-fetal CMV infection.
Objectives: The primary objective of this study is to analyze the decision-process for parents after materno-fetal infection with positive PCR after amniocentesis, to ask or not a medical termination of pregnancy (TOP). The secondary objectives are to compare ours results with literature review (pronostics factors, ultrasonographic signs and neonatal symptomatology).
Materials and Methods: This is a retrospective study, focused with a pluridisciplinary materno-fetal prenatal medical center, during a 14-year long period. Only 15 patients have been included in the study. They have been divided in 2 groups (the first group who decided to ask a TOP [n=8] and the second group who pursued the gestation [n=7]). We compare respectively their clinical, ultrasonographic, or other imagery and biological paths, before and after the birth.
Results: A total of 15/16 patients had a CMV seroconversion before 20weeks of gestation. The only infection after 20SA did not have any sequelae. The ultrasonography and the cerebral fetal MRI appeared to be very complementary for the assesment of brain injury, which is more frequent in the group with a TOP (7/8 versus 4/7). Three neonates out of 4 who had a cord positive viral blood load at birth are presenting neonatal symptoms, 2 of them will have severe brain and hearing injuries, the fourth one had no sequelae after 6months of life.
Conclusion: Only the presence of ultrasonographic major brain damages, and confirmation with MRI, had a pejorative value as prognosis factor suggesting to patients to choose a TOP. Nevertheless, other ways of research are possible to assess the prognostic value in this difficult prenatal diagnosis process.
(Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: