Understanding Cytomegalovirus (CMV) Infection in Pregnancy

What is CMV? 

Cytomegalovirus (CMV) is a common virus that belongs to the herpesvirus family. It is often asymptomatic in healthy individuals but can pose serious risks to the fetus during pregnancy.

Implications of CMV Infection During Pregnancy

1. Transmission to the Baby: CMV can be transmitted from the mother to the fetus during pregnancy, labor, or breastfeeding. Congenital CMV infection is the leading infectious cause of neurological disabilities in children.
2. Potential Risks to the Baby:
   • Hearing Loss: One of the most common outcomes of congenital CMV infection.
   • Developmental Delays: Potential for delays in motor skills, speech, and cognitive development.
   • Vision Problems: Risk of chorioretinitis and other eye conditions.
   • Microcephaly: Smaller head size due to underdevelopment of the brain.
   • Seizures: May occur in some cases.
   • Other Health Issues: Including low birth weight and jaundice.
     
3. Symptoms in Pregnant Women: Most women with CMV do not experience symptoms, but some may have mild flu-like symptoms, such as fever, fatigue, and swollen glands.
   

Prevention of CMV Infection in Pregnancy

1. Hygiene Practices:
   • Handwashing: Wash hands thoroughly with soap and water after changing diapers, feeding young children, or handling their toys.
   • Avoid Sharing Utensils: Do not share drinks, food, or utensils with young children.
   • Disinfect Surfaces: Frequently clean surfaces that may be contaminated with saliva or urine from young children.
     
2. Avoid Contact with Bodily Fluids: Be cautious with saliva and urine, particularly from children under the age of 5, as they are more likely to shed the virus.
   
3. Limit Exposure: If you have young children or work with them, take precautions to limit exposure to CMV, especially during pregnancy.
   
4. Screening and Education: Talk to your healthcare provider about CMV screening if you are at high risk or have concerns about CMV infection. Discuss the importance of education regarding CMV and its implications during pregnancy.
   
5. Consultation: If you suspect you have been exposed to CMV or are experiencing any symptoms, contact your healthcare provider for advice and potential testing.
   

Testing for CMV Infection

If there is a concern about possible CMV exposure or symptoms, your doctor may recommend specific tests to determine if you have an active or past infection. The main types of CMV testing include:

• Blood Tests: Blood samples can be analyzed to detect CMV-specific antibodies (IgM and IgG). The presence of IgM antibodies may indicate a recent infection, while IgG antibodies suggest a past or long-standing infection. Sometimes, serial blood tests are done to monitor changes in antibody levels over time, which helps determine the timing of infection. CMV avidity test can help determine if it is a recent or old infection and is very useful especially in pregnancy.
• CMV PCR Testing: In cases where a current infection is suspected, a polymerase chain reaction (PCR) test can detect CMV DNA in the blood or other body fluids. This test is highly sensitive and can identify even low levels of the virus.
• Amniocentesis: If you are pregnant and recently infected with CMV, your provider may recommend amniocentesis to test the amniotic fluid for the presence of CMV DNA. This is usually performed after the 21st week of pregnancy and can help determine if the virus has passed to the baby.
• Ultrasound Monitoring: If congenital CMV infection is suspected in a fetus, regular ultrasounds may be used to monitor fetal growth and check for signs that might suggest CMV-related complications, such as abnormal fluid accumulation or organ enlargement.

It’s important to discuss the benefits and limitations of each testing option with your healthcare provider. Timely diagnosis can help guide monitoring and management decisions throughout pregnancy, ensuring the best possible care for both you and your baby.

What to Do If You Are Infected

• Prenatal Care: Regular prenatal check-ups are essential. Your healthcare provider may monitor you and your baby closely if you are diagnosed with a CMV infection during pregnancy.
• Support Services: If your baby is diagnosed with congenital CMV, early intervention services may be beneficial for developmental support.
  

Conclusion

Cytomegalovirus infection can have significant implications during pregnancy, but through proper hygiene practices and awareness, the risks can be minimized. Consult with your healthcare provider for more information and guidance tailored to your personal health and pregnancy.