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Primary and secondary cytomegalovirus in pregnancy

^1. Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland Email: Fergus.mccarthy{at}ucc.ie (corresponding author)
^2. Discipline of Paediatrics and Child Health, University Of Sydney, NSW 2006, Australia; The Children’s Hospital at Westmead, Locked Bag 4001, Westmead 2145, Australia
^3. The Royal Women’s Hospital, Locked Bag 300, Grattan St and Flemington Rd, Parkville, Victoria 3052, Australia
^4. The Royal Women’s Hospital, Melbourne, Australia; and The Alfred Hospital, Commercial Road, Prahran, Victoria 3181, Australia; and Monash Medical Centre, Clayton Campus, 246 Clayton Road, Clayton, Victoria 3168, Australia

Key content:

• Cytomegalovirus is the commonest cause of congenital viral infection in developed countries.
  
• Infection is asymptomatic in 90% of individuals.
  
• Forty percent of pregnant women with primary infection transmit it to their fetus.
  
• Ten percent of infants with congenital cytomegalovirus display clinical manifestations at birth and are at risk of neurological sequelae.
  
• While routine antenatal testing is not currently recommended, congenital infection remains a significant obstetric management problem.
  

Learning objectives:

• To learn about the incidence, diagnosis and sequelae of cytomegalovirus in pregnancy.
  
• To become familiar with treatment options for the management of congenital cytomegalovirus.
  

Ethical issues:

• Should practitioners recommend routine cytomegalovirus screening in pregnancy?
  
• Is a randomised controlled trial necessary before offering treatment with hyperimmune globulin for congenital cytomegalovirus?
  

Please cite this article as: McCarthy FP, Jones C, Rowlands S, Giles M. Primary and secondary cytomegalovirus in pregnancy. The Obstetrician & Gynaecologist 2009;11:96–100.

Keywords congenital cytomegalovirus / ganciclovir / immunoglobulin / polymerase chain reaction / screening