Cytomegalovirus Infection in Pregnancy

Abstract

Cytomegalovirus (CMV) is a double-stranded DNA virus that is transmitted by blood, saliva, urine, or sexual activity. It can also be vertically transmitted across the placenta to the fetus during pregnancy. CMV is the most common congenital infection and the most common cause of congenital deafness.1 Diagnosing CMV infection and determining the timing of exposure are critical to counseling patients about the risks of severe neonatal sequelae. Despite the important potential impact of CMV in pregnancy, there is a significant gap between best practice and the care provided by many obstetrician-gynecologists. To a great extent, this reflects the lack of clarity about how best to approach this infection. Although we have tools to screen for CMV exposure and provide vaccination against the disease, the clinical usefulness of these interventions is still under debate. Furthermore, there are few experimental treatments to prevent congenital CMV infection. The goal of this lesson will be to update the practicing obstetrician/gynecologist on screening and appropriate therapies for this infection. How Do Primary Versus Secondary Infection and Timing of Exposure Affect Pregnancy Outcome?