Diagnosis and treatment of cytomegalovirus infection in pregnant women and newborns

Objective. To provide the clinical and laboratory characteristics of cytomegalovirus infection (CMVI) in a pregnant woman and a newborn infant. Subjects and methods. Examinations were made in a pregnant woman with reactivated CMVI confirmed by ELISA and in a neonatal girl diagnosed with acute congenital (antenatal) generalized CMVI conf irmed by ELISA and PCR. Clinical and anamnestic, laboratory and instrumental techniques, such as chest X-ray, ECG, echoCG, computed tomography and magnetic resonance imaging of the brain and spinal cord, computed tomography of the chest, and ultrasound of the abdominal cavity, were also used. Results. A follow-up was made in a 29-year-old pregnant woman, in whom a blood test screening for TORCH infections revealed anti-CMI IgM, anti-CMV IgG, an avidity index of0.389 in the absence of CMV DNA in blood and urine. The baby was born at 40-41 weeks’ gestation with a clinical symptom complex of generalized CMVI, the main manifestation of which was brain damage as multiple calcif ications and cysts. The neonate’s blood displayed anti-CMV IgM antibodies and low-grade anti-CMV IgG antibodies and a CMV DNA level of 1.5 x 102 copies/ ml. There was a high concentration of CMV DNA in urine and buccal contents. During combination therapy with cymevene, neocytotect, the baby showed a reversal of pneumonia, thrombohemorrhagic syndrome, and hepatitis with the normalization of liver transaminases, and a decrease in CMV load in blood. Conclusion. CMVI is an important problem of obstetrics, gynecology, and perinatology, which occupies a special place among intrauterine infections and affects reproductive health, which necessitates the development of new methods for the prevention and treatment of this disease.

congenital cytomegalovirus infection, pregnancy