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Cytomegalovirus infection with habitual miscarriage
Last reviewed: 23.04.2024
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Intrauterine infection with cytomegalovirus infection is the most frequent among other infections and occurs in 0.4-2.3% (on average in 1%) of all newborns, although this figure varies widely among different populations.
Many women acquire or reactivate cytomegalovirus infection during pregnancy, but only some of them transmit the virus to their fetuses, with the development of acute or long-term infection. Generalized cytomegalovirus infection in the fetus almost always occurs as a result of a primary infection in the mother, which, as a rule, proceeds asymptomatically.
At present, it is impossible to differentiate the damaging effect on the fetus of the persistence of the virus and / or its carrier against the aggravation of a latent infection. Excretion of the virus can not be a reliable indicator, since the virus and saliva release lasts for weeks and months after the primary infection, and in the urine and cervical canal it can be determined in months and even years.
Congenital cytomegalovirus infection of the newborn can lead to deafness, mental retardation and other neurological disorders.
It is not surprising that in many countries programs are being conducted to screen this infection in pregnant women with a view to reducing the consequences for the fetus. The frequency of women with antibodies to cytomegalovirus varies from 55 to 85%. Antibodies to cytomegalovirus classes IgM, IgG do not prevent the reactivation of viruses, but their presence in pregnant is extremely important for the obstetrician. The presence of antibodies means that the infection is secondary, and therefore not very dangerous for the fetus.
The diagnosis of "primary cytomegalovirus infection" is extremely difficult to deliver. To do this, you need to register all women who do not have antibodies to cytomegalovirus, and conduct regular studies at least once a month to catch the moment when antibodies appear. Their appearance and will mean that there was an infection and the patient from seronegative became seropositive for cytomegalovirus.
At a primary cytomegalovirus infection, 30-40% of newborns fall ill.
Of these, 10-15% are born with symptoms of the disease, 20-30% of them die. Of the survivors, 90% are disabled and only 10% recover.
In secondary infection or reactivation of infection, 0.2-1% of newborns are born. With secondary infection, children do not die, but in 5-10% of cases may have neurological consequences, healthy are 90-95%. If at the time of birth the child has no symptoms of infection, then 99% of the children will be healthy.
Perinatal infection can be obtained transplacental from mother to fetus, or ascending from the infected cervix through intact membranes. The primary infection is the most dangerous in the first and second trimesters of pregnancy, although intrauterine infection can be during reactivation, but it occurs with much less complications for the fetus.
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