DETECTION AND COMPARISON OF CYTOMEGALOVIRUS DNA LEVELS IN AMNIOTIC FLUID AND FETAL ASCITES IN A SECOND-TRIMESTER FETUS WITH MASSIVE ASCITES, HYPERECHOGENIC BOWEL, VENTRICULOMEGALY AND INTRAUTERINE GROWTH RESTRICTION

作者：Chen Chih Ping^*; Su Yi Ning; Chern Schu Rern; Wang Tao Yeuan; Tsai Fuu Jen; Lin Hung Hung; Wu Pei Chen; Wang Wayseen

来源：Taiwanese Journal of Obstetrics & Gynecology, 2010, 49(2): 206-210.

DOI：10.1016/S1028-4559(10)60044-7

• congenital infection
• cytomegalovirus
• DNA
• fetal ascites
• prenatal diagnosis

Objective: To present a prenatal diagnosis of congenital cytomegalovirus (CMV) infection in a pregnancy with fetal ascites
Case Report: A 33-year-old, gravida 6, para 2, woman was referred to a hospital at 20 weeks of gestation for management of fetal ascites The woman had not experienced recent rubella or herpes simplex infections The maternal blood group was O and Rh(D)-positive The maternal serum thalassemia and syphilis screen results were negative Fetal ascites was first noted at 17 weeks of gestation At 18 weeks, she underwent amniocentesis revealing a 46,XX karyotype At 20 weeks of gestation, maternal serum CMV IgG and CMV IgM were positive At 21 gestational weeks, prenatal ultrasound showed fetal ascites, hyperechogenic bowel, ventriculomegaly, and intrauterine growth restriction Repeated amniocentesis showed CMV DNA levels of 9 72 x 10(5) copies/mL and 6 03 x 10(5) copies/mL in amniocytes and amniotic fluid supernatant, respectively Paracentesis showed CMV DNA levels of 1 64 x 103 copies/mL and 114 copies/mL in ascitic cells and ascitic supernatant, respectively The pregnancy was terminated Postnatally, CMV DNA was detected in the umbilical cord, amnion, placenta, cord blood, lungs, liver and brain by quantitative real-time polymerase chain reaction
Conclusion: A prenatal diagnosis of fetal ascites in association with ventriculomegaly, hyperechogenic bowel and intrauterine growth restriction should alert physicians to congenital CMV infection in addition to aneuploidy The present case provides evidence that CMV DNA levels are higher in amniotic fluid (amniocytes and amniotic fluid supernatant) than in ascites (ascitic cells and ascitic supernatant) in cases of congenital CMV infection [Taiwan J Obstet Gynecol 2010,49(2) 206-210]

• 出版日期2010-6
• 单位中国医科大学