Regression of fetal cerebral abnormalities by primary cytomegalovirus infection following hyperimmunoglobulin therapy

Prenat Diagn. 2008 Jun;28(6):512-7. doi: 10.1002/pd.2013.

Abstract

Objective: To assess the effects of maternal and intra-amniotic hyperimmunoglobulin (HIG) infusions among cytomegalovirus (CMV) infected fetuses with ultrasound abnormalities following a primary CMV infection.

Patients and methods: The subjects were fetuses with CMV-associated cerebral and other ultrasound abnormalities. Three mothers were treated with HIG infusions during pregnancy and two were untreated. Fetal ventricle size, organ echodensity and placental thickness were measured by ultrasound before and after HIG infusions. The children were evaluated between 3 and 7 years of age.

Results: The ventriculomegaly of all three fetuses of HIG-treated mothers regressed and the ascites, hepatic echodensities, periventricular echodensities, and intestinal echodensities disappeared. Their sensorial, mental and motor development was normal at 4, 4.7, and 7 years of age. In contrast, both infants born of untreated mothers had signs and symptoms of severe CMV cerebropathy.

Conclusion: The outcomes of the infants born to HIG-treated mothers support the efficacy of HIG as a treatment for CMV-infected fetuses with ultrasound cerebral abnormalities.

MeSH terms

  • Adult
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy*
  • Female
  • Fetal Diseases / diagnostic imaging
  • Fetal Diseases / drug therapy*
  • Fetal Diseases / virology
  • Humans
  • Immunoglobulins / administration & dosage*
  • Immunologic Factors / administration & dosage*
  • Infant, Newborn
  • Male
  • Nervous System Malformations / diagnostic imaging
  • Nervous System Malformations / drug therapy*
  • Nervous System Malformations / virology
  • Pregnancy
  • Remission Induction
  • Ultrasonography, Prenatal

Substances

  • Immunoglobulins
  • Immunologic Factors