Late onset of ultrasound abnormalities in a case of periconceptional congenital cytomegalovirus infection

. Familial CPL is very uncommon, with only sixpreviously reported cases, and may represent a distinctnosological entity. Prenatal detection largely relies onidentification of the non-specific findings of hydrothoraxand hydrops.We report two cases of CPL in consecutive pregnancies.A 29-year-old primigravida was referred to us at22 weeks’ gestation for fetal bilateral pleural effusionwith ascites. Her medical history was unremarkable.Ultrasound examination of the fetus revealed nomorphological anomaly and normal peak systolic velocityin the middle cerebral artery (indicating absence ofanemia) but absence of flow in the ductus venosusduring atrial contraction. At 23 weeks’ gestation pleuralfluid (52 mL) was removed and amniotic fluid samplingrevealed a normal karyotype (46,XX) and no metabolicdisease. Screening for infectious diseases (