Hagay Z J, Biran G, Ornoy A, Reece E A
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Am J Obstet Gynecol. 1996 Jan;174(1 Pt 1):241-5. doi: 10.1016/s0002-9378(96)70401-5.
The purpose of this study was to review the accuracy of current tests used for the diagnosis of in utero cytomegalovirus infection and to discuss the potential value of preconceptional and postconceptional screening programs for prevention of congenital infection.
A computer-assisted search was performed for relevant English language publications between 1987 and 1994. We identified 119 cases of suspected intrauterine cytomegalovirus infection in which either amniotic fluid or fetal blood had been analyzed antenatally.
Congenital cytomegalovirus infection affects 0.5% to 2.5% of all newborns. The rate of transmission to the fetus after primary infection during pregnancy ranges from 15% to 50%. Of the fetuses infected in utero, 10% exhibit congenital cytomegalovirus syndrome. Evaluation of 119 cases of suspected infection has shown that polymerase chain reaction and cultures of amniotic fluid are the most reliable tests for prenatally determining the presence of viral particles. However, efficacy of routine antenatal screening in reducing the rate of fetal disease is limited.
It is concluded that at present the accuracy of tests used for the diagnosis of in utero cytomegalovirus infection is undetermined. Serologic screening of all pregnant women is of limited value and at present is not recommended.
本研究旨在回顾当前用于诊断宫内巨细胞病毒感染的检测方法的准确性，并探讨孕前和孕后筛查项目对预防先天性感染的潜在价值。
对1987年至1994年间的相关英文出版物进行计算机辅助检索。我们确定了119例疑似宫内巨细胞病毒感染病例，这些病例在产前对羊水或胎儿血液进行了分析。
先天性巨细胞病毒感染影响所有新生儿的0.5%至2.5%。孕期初次感染后胎儿的传播率为15%至50%。在宫内感染的胎儿中，10%表现出先天性巨细胞病毒综合征。对119例疑似感染病例的评估表明，聚合酶链反应和羊水培养是产前确定病毒颗粒存在的最可靠检测方法。然而，常规产前筛查在降低胎儿疾病发生率方面的效果有限。
得出结论，目前用于诊断宫内巨细胞病毒感染的检测方法的准确性尚未确定。对所有孕妇进行血清学筛查价值有限，目前不建议进行。
