Donner C, Liesnard C, Content J, Busine A, Aderca J, Rodesch F
Department of Obstetrics and Gynecology, Hôpital Universitaire Erasme, Free University of Brussels, Belgium.
Obstet Gynecol. 1993 Oct;82(4 Pt 1):481-6.
To determine the feasibility of prenatal diagnosis of fetal cytomegalovirus (CMV) infection.
Fifty-two pregnant women were investigated in our unit between October 1985 and July 1992. The diagnostic procedures included ultrasound examination, amniocentesis, and fetal blood sampling. Specific tests for CMV infection included specific immunoglobulin (Ig) M antibodies, viral culture, and amplification of CMV DNA by polymerase chain reaction. Nonspecific tests included white blood cell count, hemoglobin, hematocrit, platelets, and gamma-glutamyl transferase determination.
The combination of tests allowed an antenatal diagnosis of CMV in 13 of the 16 infected fetuses (sensitivity 81%). Amniocentesis allowed the diagnosis in 12 of the 13 antenatally diagnosed cases. The sensitivity of CMV IgM antibody detection in fetal blood was 69%. The culture of fetal blood was never positive. Thrombocytopenia was present in six cases, and ultrasound was abnormal in five.
Amniotic fluid is the best sample to diagnose CMV infection, and fetal blood sampling and sonography are important to assess the fetal condition. Our experience underscores the importance of repetitive sampling.
确定胎儿巨细胞病毒（CMV）感染产前诊断的可行性。
1985年10月至1992年7月期间，对本单位的52名孕妇进行了调查。诊断程序包括超声检查、羊膜穿刺术和胎儿血样采集。CMV感染的特异性检测包括特异性免疫球蛋白（Ig）M抗体、病毒培养以及通过聚合酶链反应扩增CMV DNA。非特异性检测包括白细胞计数、血红蛋白、血细胞比容、血小板以及γ-谷氨酰转移酶测定。
这些检测组合使得16例感染胎儿中的13例得以产前诊断CMV（敏感性81%）。羊膜穿刺术在13例产前诊断病例中的12例中做出了诊断。胎儿血中CMV IgM抗体检测的敏感性为69%。胎儿血培养从未呈阳性。6例出现血小板减少，5例超声检查异常。
羊水是诊断CMV感染的最佳样本，胎儿血样采集和超声检查对于评估胎儿状况很重要。我们的经验强调了重复采样的重要性。
