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9/26/2014  |   4:30 PM - 6:00 PM   |  

Blood phenotype in severely and mild-moderately affected fetuses infected with cytomegalovirus

In cases of confirmed cytomegalovirus (CMV) infection, certain parameters in fetal blood have correlated with neonatal outcome. Material and methods: Seven-year cross sectional study. In fetuses with abnormal US/MRI findings and confirmed CMV infection in amniotic fluid, a fetal blood sampling was performed for evaluation of platelet count, beta-2 microglobulin, gamma-glutamyl transferase (GGT), presence or absence of IgM antibody, and DNAaemia. Blood parameters were compared in severely affected fetuses (severe cerebral abnormalities or fetal hydrops) and mild-moderately affected ones (isolated extra-cerebral or mild cerebral abnormalities) diagnosed at sonographic examination, and confirmed by postnatal evaluation or histological findings after termination of pregnancy (TOP). Results: Fetal blood sampling was obtained in 17 cases: 10 severely and 7 moderately damaged fetuses. The cordocentesis was performed at a mean gestational age of 26.2 weeks. Among the severely damaged fetuses there were 9 TOP and one fetal demise. Among the mild-moderately damaged, there were 5 TOP and 2 alive newborns, one with unilateral hearing loss and one asymptomatic. A low platelet count (< 100000/µl) and high levels of GGT (?151 UI/l) were observed in 62% and 67% of fetuses, respectively, and were found more often among the severely damaged fetuses (78% vs 43% and 83% vs 50%) although the difference was not statistically significant (p=0.15 and p=0.22). High levels of DNAaemia (>30 000 copies/ml) and beta-2 microglobulin (>11.5 mg/l) were found in 64% and 50% of fetuses, respectively; however, they were observed more often in mild-moderately damaged than in severely affected ones (83% vs 50% p=0.2 and 67% vs 37% p=0.28) although the difference was again not significant. IgM positivity was similar in both groups (37% and 29%). Conclusions In fetuses with abnormal US/MRI findings and confirmed CMV infection, no significant differences were observed in blood phenotype with respect to the degree of fetal damage.

Anna Gonce (POC,Primary Presenter), agonce@clinic.cat;
Dr. Anna Goncé is Consultant at the Maternal-Fetal Medicine Department of the Hospital Clínic of Barcelona (Spain) where she has been working since 2001. PhD in Medicine. She is responsible for the Perinatal Infections Unit and co-responsible for the Multiple Pregnancy Unit. She is specialized in the infections of the TORCH Group and is a member of the European Congenital Cytomegalovirus Initiative. She has worked actively in the development of several clinical guidelines for the Department. She has published in international and national journals and has participated as an invited speaker at several courses and conferences. She is the director of the national biennial course on Infections on Maternal-Fetal Medicine which takes place at the Hospital Clinic of Barcelona. She is a member of the Catalan Society of Maternal-Fetal Medicine

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Francesc Figueras (Author), ffiguera@clinic.cat;
Dr. Francesc Figueras is the Head of the Fetal Growth and Preeclampsia Unit. BCNatal. Hospital Clinic. University of Barcelona. Spain

Laura Garcia (Author), lagarcia@clinic.cat;
Dr. Laura Garcia is a Specialist at the Maternal-fetal Medicine Department. Hospital Clinic. University of Barcelona. Spain

Alfons Nadal (Author), anadal@clinic.cat;
Dr. Alfons Nadal is a Consultant at the Department of Pathology. Hospital Clínic. University of Barcelona. Spain

M. Angeles Marcos (Author), mmarcos@clinic.cat;
Dr. MA. Marcos is Head of the Virology Department. Microbiology Service. Hospital Clínic. University of Barcelona. Spain

Gemma Arca (Author), garca@clinic.cat;
Dr. Gemma Arca is a Senior Specialist at the Department of Neonatology. Hospital Clínic. University of Barcelona. Spain

Bienvenido Puerto (Author), bpuerto@clinic.cat;
Dr. Bienvenido Puerto is the Head of the Ultrasound Section-Fetal Medicine Area at BCNatal. Hospital Clínic. University of Barcelona. Spain

Eduard Gratacos (Author), gratacos@clinic.cat;
Dr. Eduard Gratacos is the Head of Maternal-fetal Medicine Department BCNatal. Hospital Clinic University of Barcelona. Spain

Presentation:
532AnnaGonce.pdf

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