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Cytomegalovirus (CMV) Symptoms causes and treatment

Cytomegalovirus infection in a pregnant woman can cause malformations in the fetus if it is infected. This is why it is important to know if you are at risk of contracting this disease and to protect yourself with hygiene rules if this is the case.

Definition of cytomegalovirus

Cytomegalovirus is a virus of the herpesvirus family ( Herpesviridae ). Its contamination is through contact with saliva, tears or urine, or genital secretions, but also by projections during coughing. This virus occurs most often during childhood.

Cytomegalovirus during pregnancy

Cytomegalovirus infection is the most common maternal-fetal viral infection.

A majority of pregnant women had a cytomegalovirus infection during childhood. They have antibodies against the virus. They may have a reactivation of the virus during pregnancy but the risk of transmission to the fetus is then very low. For other future mothers, this virus represents a danger if it occurs for the first time (primary infection) during the first trimester of pregnancy and up to 27 weeks of amenorrhea (27 weeks or 25 weeks of pregnancy). In the case of primary infection of the mother, the contamination is transmitted by blood to the fetus in half of the cases. Cytomegalovirus can cause developmental delay, brain malformations, or deafness, but most babies with congenital cytomegalovirus infection do not have any symptoms at birth. However, a small number of babies born unaffected can develop neurosensory sequelae before the age of 2 years.

Cytomegalovirus: what is your immunological status?

A blood test taken early in pregnancy provides information on the immunological status of cytomegalovirus. If the serodiagnosis shows an absence of antibodies, you must respect hygienic conditions during your pregnancy to avoid the cytomegalovirus.

Gynecologists have more serodiagnostics done during pregnancy to see if the pregnant woman has not had a cytomegalovirus infection. If so, they can set up fetal monitoring. However, routine screening for cytomegalovirus infections during pregnancy is not recommended by public health authorities. There is indeed no treatment and health professionals also fear an excess of diagnosis and an excessive use of voluntary termination or medical pregnancy. Serologic testing for CMV is recommended for women with influenza-like symptoms during pregnancy or after the detection of ultrasound signs suggestive of CMV infection.

Symptoms of cytomegalovirus

CMV infection in an adult often does not show any symptoms, but CMV can cause a viral syndrome that resembles the flu. Main symptoms: fever, headache, severe fatigue, rhino-pharyngitis, ganglia …

Cytomegalovirus during pregnancy: how do I know if my baby is infected?

You had a cytomegalovirus infection before 27 SA? To find out if your fetus has an attack, an ultrasound monitor is put in place. An amniotic fluid sample (amniocentesis) can be performed from 22 AS to determine if the virus is present in the amniotic fluid.

If the ultrasound is normal and the amniotic fluid does not contain the virus, it’s reassuring! Ultrasound monitoring will however occur throughout pregnancy and CMV screening will be done in the baby at birth.

If the ultrasound reveals an abnormality suggestive of a CMV infection (growth retardation, hydrocephalus (fluid accumulation inside the skull) and if the virus is present in the amniotic fluid, the fetus has a severe lesion. medical termination of pregnancy (IMG) may be offered.

If the virus is present in the amniotic fluid but the normal ultrasound, it is not possible to know if the fetus was contaminated or not. Pregnancy can continue with ultrasound monitoring.

Prevention of cytomegalovirus

To protect your baby in-utero, it is important to minimize the risk of getting Cytomegalovirus if you are at risk. Cytomegalovirus is often transmitted by children under 3 years old, if you are in contact with young children during your pregnancy (whether yours or in the course of your work) be sure to wash your hands after changing diapers or wiped secretions and do not share your cutlery with them. It is also advisable not to kiss his young children on the mouth.

Prevention and treatment of cytomegalovirus in utero?

Two treatments for congenital CMV infection are currently under study:

  • antiretroviral therapy
  • a treatment that involves injecting specific anti-CMV immunoglobulins

The goal of these treatments is to reduce the rate of transmission to the fetus in case of maternal infection and to reduce the rate of sequelae in case of fetal infection.

A CMV vaccine that could be given early in pregnancy to HIV-negative women for CMV infection is also under study.

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