NON-INVASIVE MANAGEMENT OF MATERNAL CYTOMEGALOVIRUS INFECTION DURING PREGNANCY

Problem statement Primary maternal cytomegalovirus (CMV) infection occurs in 0.8-6% of all pregnancy worldwide. The vertical transmission rate is 32%. 87.3% of CMV-infected newborns are asymptomatic at birth and 10-15% of these will develop CMV-related sequelae, particularly sensorineural hearing loss (SNHL). Up until now, no antenatal treatment of CMV infection has been satisfactorily validated. Amniocentesis, the gold standard to confirm fetal congenital infection, does neither completely discriminate between infected and uninfected newborn, nor does it predict neurological outcome. For these reasons, it is considered an invasive method and the indication in asymptomatic foetuses is still debated. We propose a first-line non-invasive fetal management using systematic ultrasound (US) and cerebral magnetic resonance imaging (MRI) for primary maternal CMV infection. An amniocentesis is performed only if the medical imaging screening highlights abnormal findings.