Cytomegalovirus infection in pregnant women

The article was professionally consulted with Master, Doctor Dinh Thanh Ha - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Nha Trang International General Hospital.

Cytomegalovirus infection is very common in humans and usually does not cause harm. A survey in the United States found that 50 to 80 of every 100 adults by the age of 40 will be infected with CMV (50-80%). Once infected, the body will carry this virus for life. However, if the mother is infected with CMV during pregnancy, she can transmit the virus to the fetus, causing congenital CMV infection syndrome that can have serious consequences for the fetus and newborn baby.

Most healthy adults and children infected with CMV have no symptoms and don't even know they have CMV infection. Some people may experience flu-like symptoms of CMV infection such as fever, sore throat, fatigue, and swollen lymph nodes. This is also a symptom of many different diseases, so in general most people do not know they have been infected with CMV.
However, in people whose immune system (the system that helps the body fight against pathogens) is weakened such as:
Having cancer, Taking immunosuppressive drugs, Organ transplant recipients, People infected with HIV. When infected with CMV or CMV already in the body, the virus can go into an active state with serious consequences.

Cytomegalovirus is present in most body fluids, including saliva, tears, urine, and genital secretions, as well as in transplanted organs. During pregnancy, a mother can acquire primary, recurrent, or reactivated CMV infection and then pass it on to the fetus, which is thought to be transplacental. In the above cases, the rate of infection to the fetus is highest if the mother has primary CMV infection during pregnancy, this rate can be up to 40-45%. Primary CMV infection or infection during the first trimester of pregnancy increases the severity of the infection in the neonate.
When the mother is infected, the virus will enter the white blood cells and follow the white blood cells to cross the placenta. In women who were seropositive for cytomegalovirus prior to pregnancy, CMV reactivation can still lead to congenital CMV infection. The rate of CMV transmission to the fetus in pregnant women who were immune before pregnancy is only about 1% compared with 40% in women infected during pregnancy, and the complications encountered in the baby are often milder.
In other words, congenital cytomegalovirus infections in mothers who were immune to CMV before pregnancy could be due to a new strain of CMV. In addition to intrauterine transmission, infection with this virus can also occur during the perinatal cytomegalovirus phase by exposure to genital secretions at birth.
Postpartum cytomegalovirus infection can occur from exposure to breast milk, blood products, or organ transplantation. Full-term infants infected with CMV from breast milk often show no symptoms due to the presence of antibodies passed on from the mother. In contrast, extremely preterm infants most often show symptoms after CMV infection from breast milk because the baby does not receive enough antibodies from the mother, while the baby's immune system has not yet developed. These CMV infections often present with sepsis-like symptoms, including respiratory symptoms (eg, pneumonia), hepatosplenomegaly, leukopenia, thrombocytopenia, and lymphocytosis. The risk of CMV transmission in preterm infants can be reduced by pasteurizing breast milk, using blood products that have decreased white blood cell counts, and using blood or milk from negative donors. CMV.

If the mother is confirmed positive for cytomegalovirus, the doctor will order further tests to check if the fetus has been infected with this virus by amniocentesis and testing of amniotic fluid obtained or tested. by ultrasound to see if the baby has signs of infection or not?
To treat cytomegalovirus, your doctor may prescribe the antiviral drugs acyclovir or valacyclovir.
Currently, scientists around the world are still researching vaccines against cytomegalovirus as well as methods to prevent mother-to-child transmission of CMV.

Cytomegalo virus is a dangerous disease virus, it is very important to follow preventive measures. Accordingly, preventive measures are as follows:
Use condoms when having sex with someone infected with cytomegalo virus; Wash hands immediately after changing diapers, wiping nasal secretions... for children; Wash hands immediately after using the toilet, pack and dispose of soiled diapers and tissues after use; Do not share utensils with someone infected with cytomegalo virus. If you have any unusual symptoms, you should be examined and consulted with a specialist.

Pregnant women will be tested for Cytomegalo virus infection when:
Most women infected with CMV have no symptoms, but some women have flu-like symptoms. When having such symptoms, pregnant women should be tested for CMV. Contact with a patient who has been infected with CMV. Ultrasound detected abnormalities in the fetus. Common manifestations in the case of congenital CMV infection include: microcephaly, hydrocephalus (ventricular dilation), intrauterine growth retardation, intracranial calcification, intra-abdominal calcification, hepatomegaly , fetal edema, oligohydramnios or polyhydramnios, etc. However, it should be noted that the above manifestations do not always predict fetal damage. The sensitivity of fetal assessment by ultrasound (the ability to detect the number of abnormalities in the total number of abnormalities) is only about 30-50%. Pregnant women with a weak immune system. If you are identified as having CMV infection for the first time during your pregnancy, it is important to have your baby tested for CMV infection as soon as possible after birth. The introduction of routine testing to detect CMV infection in pregnant women is still controversial. Cytomegalovirus infection in pregnant mothers is very dangerous, so pregnant women need to have regular health checkups, do routine tests as prescribed by doctors to detect abnormal conditions early. From there, there is a direction for timely examination and treatment.
The Obstetrics Department of Vinmec International General Hospital has been highly appreciated by customers for its professional quality as well as professional care services.
Comprehensive mother and baby care : Comprehensive mother & baby health care, from before - during - after pregnancy fully; prenatal and postnatal screening for infants and mothers; heel test; maternity package ; pre-marital examination; prenatal care and counseling; cord blood storage. Children receive the best care from birth: right after the baby is born, the baby is skin-to-skin with the mother, the umbilical cord is cut by the father, and is monitored and cared for in the special care room for a few days. 12 hours for early detection of transient respiratory failure or other medical conditions. The baby is fully vaccinated. The birth team not only has obstetricians and midwives, but also has pediatricians on duty, monitoring to handle problems arising for the baby during the birth process. Modern and advanced techniques: Painless delivery by special anesthetic techniques. Treatment and care for extremely preterm infants < 27 weeks - Vinmec is the only hospital in the North that can save the lives of babies born 24 weeks premature. Outstanding equipment: The room is designed according to international hotel standards, with modern equipment such as: specialized transport incubators with ventilators, blood suction, pressure controlled oxygen tubes; deafness screening machine, brain cooling machine to treat asphyxia; CFM brain function monitor; Monitor 5 parameters; Resuscitation bed with built-in heating lamp.