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PREGNANCY AND CITOMEGALOVIRUS INFECTION


Cytomegalovirus infection is a very common viral infection.

Most people get the infection in childhood without even realizing it.

However, when the infection during pregnancy is transmitted to the baby, it can lead to conditions such as growth retardation, deafness, mental retardation, delayed walking, delayed learning.

This risk is especially higher in expectant mothers who have not had a previous infection.

What is cytomegalovirus infection?

Cytomegalovirus infection is an infection with the virus called CMV (Cytomegalovirus).

It is quite common in the community and is one of the most common neonatal infections.

When adequate diagnostic methods are used, this virus can be detected in approximately 1% of newborns.

How is it found?

CMV can be transmitted to people by droplets (from other people by breathing in the common air), or it can be transmitted by contact with body fluids such as saliva, urine, feces, breast milk, vaginal secretions, semen.

Other modes of transmission are blood transfusions and sexual intercourse.

Another clinically important mode of transmission is transmission from the mother to her unborn baby during pregnancy.

Infection is often experienced in childhood, and adults who have not had the infection yet pass the virus from their children, who get the virus in public places such as school.

Due to the prevalence of transmission routes, at least 50% of the population is found to have had this infection before.

This rate may be even higher (80%) in the lower socioeconomic level. The likelihood of encountering an infection increases with age.

What are the symptoms of cytomegalovirus infection?

Most CMV infections are asymptomatic.

This includes infections during pregnancy.

Non-specific signs and symptoms such as fever, sore throat, lymphadenopathy (swelling of lymph nodes), and joint pain are observed in only 15% of mothers who have an infection.

Infections are more common and cause more serious symptoms, especially in people whose immune system is suppressed for various reasons (such as AIDS patients, those who have to use immunosuppressive drugs due to organ transplantation).

First-time CMV infection creates an immune response in the body, but this immunity is not complete.

After this initial infection, called a primary infection, the virus settles in the body and can cause repeated infections at various times.

Infections that occur at different times later are called recurrent infections. Recurrent infections are much less frequent and with milder symptoms.

What is the importance of infection during pregnancy?

Infection during pregnancy can pass to the baby through the placenta.

If the infection is transmitted to the baby;

Intrauterine growth retardation (IUGR),

Microcephaly (small head),

Intracranial calcification (calcification areas in the brain tissue),

Chorioretinitis (eye infection)

Blindness,

mental retardation,

Motor developmental delay (such as walking late),

Hearing loss, enlarged liver and spleen,

It can cause signs and symptoms such as jaundice and anemia.

While some of these conditions, which are caused by the effect of virus infection, are obvious immediately after birth;

(such as jaundice, small head, low birth weight), some may occur as the baby grows (such as deafness, delayed walking, mental retardation).



The majority of expectant mothers have had this infection before they became pregnant.

As a result, although partial immunity is formed, in these expectant mothers;

When recurrent infection occurs, the risk of transmission to the baby is very low, and when it is transmitted to the baby, the risk of creating undesirable situations in the baby is very low.



The picture changes in expectant mothers who have never had this infection before.

Primary infection occurs during pregnancy in 1-4% of these expectant mothers.

In this case, since there is no immunity in the body, the risk of transmission of the infection to the baby is high (40% infection is transmitted to the baby).

However, when a baby is infected, this does not necessarily mean that it will cause an abnormal condition. Approximately 90% of these expectant mothers have a normal baby at birth.

A small number of these normal babies may develop the effects of infection at a later time.

In the 10% of infants with signs of infection at birth, the probability of sequelae due to infection is higher.

How is it diagnosed?

A four-fold increase in cytomegalovirus-specific IgG antibody in the blood in two separate measurements, or detection of IgM antibody in a single sample taken is diagnostic of primary infection.

IgG elevation alone (IgM should not be elevated) in patients with previously determined IgG diagnoses recurrent infection.

However, erroneous results are also relatively common, as CMV can cross-react with other viruses.

In some cases, this infection is suspected by detecting IUGR (intrauterine growth retardation), microcephaly and/or calcifications in the brain tissue on ultrasound.

Diagnosis is made by the level of antibodies in the blood or by further examination of the blood taken from the baby by cordocentesis.

What can be done to prevent pregnancy?

every pregnancy


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