Diagnosis of severe fetal cytomegalovirus infection from amniotic fluid in the third trimester of pregnancy

Abstract

rr~~~~ ARE, at present, two reports in the literature describing the isolation of cytomegalovirus (CMV) from amniotic fluid, obtained during pregnancy by means of amniocentesis.’ In both cases there was a severe CMV infection of the mother with an asymptomatic infection in the neonate. We present a case in which CMV was recovered from the amniotic fluid at 32 weeks of amenorrhea in a woman with an asymptomatic CMV infection, who was eventually delivered of an infant with a severe congenital CMV syndrome. A 19-year-old, Caucasian, primigravid woman was admitted at 30 weeks of pregnancy with the diagnosis of insufficient fetal growth. The course of pregnancy had been uneventful and, in particular, there was no history of malaise or fever during pregnancy. The uterus was about the size of a 28 weeks’ pregnancy with a single fetus in cephalic position. The biparietal diameter of the fetal head as measured by ultrasound was 6.8 cm, being far below the fifth percentile of the usual standard curve, and the fetal chest area was with 40 sq cm on the fifth percentile of our reference curve. The routine laboratory tests revealed no abnormalities, except for a slightly elevated serum bilirubin concentration (18 pmoles/L). On serologic screening for infections, the complement-fixation