Cytomegalovirus, commonly known as CMV, is a prevalent member of the herpes virus family. By the time individuals reach 40 years old, about half of them will have contracted CMV. In most cases, a CMV infection is temporary, often without noticeable symptoms, and the virus remains dormant in the body. However, if a pregnant woman contracts CMV for the first time during her pregnancy, or experiences a reactivation of a previous infection, it raises concerns regarding fetal health. This article will explore the potential birth defects linked to congenital CMV and offer guidance on how to safeguard both you and your baby.
Congenital CMV Birth Defects: Risks in the Womb
Not every infant born to a mother with a CMV infection will develop congenital CMV, and even among those who do, the long-term effects can vary significantly. It’s crucial to understand the risks, as some may have lasting implications for your child’s quality of life.
In the United States, approximately 1 in every 150 to 200 infants is born with congenital CMV, making it the most common congenital viral infection. Despite this statistic, only about 20% of these babies will show any adverse effects or long-term complications.
CMV can be transmitted from the mother’s bloodstream through the placenta to the developing baby. If a mother is already infected before pregnancy, the likelihood of passing it to her baby is low. However, the risk increases if she contracts a different strain of the virus during pregnancy or if the existing virus reactivates.
The chance of transmitting CMV to the baby is significantly higher during a primary infection in the third trimester, estimated at 40-70%, compared to 30-40% in the first or second trimesters.
Can Congenital CMV Affect My Baby?
CMV can indeed harm a developing fetus at any point during pregnancy. While the risk of fetal death from CMV is minimal, there have been instances where seizures were observed in fetuses infected with congenital CMV. Fortunately, many of these infants manage to survive and thrive.
Ultrasound scans can reveal several abnormalities that may suggest a congenital CMV infection. These include:
- Organomegaly (enlarged organs such as the spleen and liver)
- Abnormal dilation of brain ventricles, ureters, or renal pelvis
- Intracranial calcifications
- Microcephaly
- Thickened placenta
- Fetal hydrops
- Ascites
- Echodensities in the liver, intestines, or periventricular areas.
While these indicators might point to congenital CMV, they can also be associated with various other conditions.
Testing for CMV in Utero
If there are concerns regarding CMV, amniocentesis can be performed to assess the baby’s status while still in the womb. This procedure involves using ultrasound guidance to insert a needle into the amniotic sac to collect fluid for testing. Amniocentesis is typically done during the 14-20 week period or at the end of the third trimester. Although beneficial, this procedure carries risks, including miscarriage (1 in 200 to 1 in 400), infection, and potential injury to the fetus.
If any abnormalities were detected on ultrasound, it’s essential to discuss amniocentesis with your healthcare provider. The potential benefits of obtaining results often outweigh the risks. Rapid identification of congenital CMV can allow for timely treatment with antiviral medications post-birth, offering a better outcome than if testing occurs only after delivery.
What Are the Treatment Options for Congenital CMV?
If a baby is diagnosed with congenital CMV in utero, there are a few treatment avenues that parents and healthcare providers can explore. Early intervention is key, so consult your doctor about the best course of action.
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In summary, congenital CMV poses significant risks, but awareness and proactive measures can make a difference in outcomes for your baby. Always consult your healthcare provider for personalized advice and support.