Diagnostic des infections maternofœtales à cytomégalovirus (HCMV)

Abstract

Human cytomegalovirus is the most common cause of viral intrauterine infection, affecting 0,5 to 2 % of all live births, and causing psychomotor and perceptual sequelae in about 10 % of infected children. In France, about 50 % of pregnant women are HCMV seronegative. Seroconversion rate is about 1,6 % and rate of transmission to the fetus after primary infection during pregnancy reach 40 %. Contamination of fetus rarely occurs after maternal reactivation or reinfection. In pregnant women, diagnosis of HCMV primary infection is essentially based on the detection of IgG and IgM antibodies. Diagnosis of congenital infection is possible by detecting HCMV in the amniotic fluid. As all HCMV maternal infections do not induce disease in fetuses, prognostic markers are needed. Some factors, such as viral load in amniotic fluid or in fetal blood, or level of IgM antibody in fetal blood, may be predictive of sequelae, but these data require further studies.