Virology Division, Dept of Microbiology, SEALS, Prince of Wales Hospital, Randwick, Australia.
J Infect Dis. 2011 Jun 1;203(11):1526-33. doi: 10.1093/infdis/jir121.
Human cytomegalovirus (CMV) is the most common congenital infection in developed countries and is a known cause of intrauterine fetal death. We examined CMV infection in stillbirths and the relationship with histopathological findings at autopsy.
We collected liver, kidney, and placenta specimens from 130 stillbirths. CMV DNA and protein were detected using polymerase chain reaction and immunohistochemistry, along with routine autopsy of stillborn infants.
Overall, CMV DNA was detected in 15% of singleton, >20-week stillborn infants. CMV DNA was detected in kidney (9%), liver (11%), and placenta (5%) specimens, with 75% of infections confirmed by immunohistochemistry. Fetal thrombotic vasculopathy was the only histopathological abnormality associated with CMV infection (in 60% CMV-infected vs 28% uninfected stillbirths P = .010).
Stillbirth has multiple etiologies. However, the detection of CMV DNA in 15% of fetal tissues or placentae suggests a strong association between CMV infection in pregnancy and stillbirth. Molecular testing during postmortem investigation has an important role to determine the contribution of CMV infection.
人巨细胞病毒（CMV）是发达国家最常见的先天性感染，也是导致宫内胎儿死亡的已知原因。我们研究了死胎中的 CMV 感染情况及其与尸检时组织病理学发现的关系。
我们从 130 例死胎中收集了肝、肾和胎盘标本。使用聚合酶链反应和免疫组织化学检测 CMV DNA 和蛋白，同时对死胎进行常规尸检。
总体而言，15%的单胎、>20 孕周的死胎中检测到 CMV DNA。CMV DNA 存在于肾脏（9%）、肝脏（11%）和胎盘（5%）标本中，75%的感染通过免疫组织化学得到确认。胎儿血栓性血管病变是唯一与 CMV 感染相关的组织病理学异常（CMV 感染的死胎中为 60%，未感染的死胎中为 28%，P=0.010）。
死胎有多种病因。然而，在 15%的胎儿组织或胎盘中检测到 CMV DNA，提示妊娠期间 CMV 感染与死胎之间存在很强的关联。尸检期间的分子检测在确定 CMV 感染的贡献方面具有重要作用。
