Placental Enlargement in Women with Primary Maternal Cytomegalovirus Infection Is Associated with Fetal and Neonatal Disease
Background. Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. Methods. The study included 92 women with prima...
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| Veröffentlicht in: | Clinical infectious diseases 2006-10, Vol.43 (8), p.994-1000 |
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| description | Background. Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. Methods. The study included 92 women with primary CMV infection during pregnancy and 73 CMV-seropositive pregnant women without primary CMV infection. Neonatal CMV transmission was determined by CMV culture of urine samples. Thirty-two women were treated with CMV hyperimmune globulin to either prevent or treat intrauterine CMV infection. Maximal placental thickness was measured by longitudinal (nonoblique) scanning with the ultrasound beam perpendicular to the chorial dish. Programmed placental ultrasound evaluations were performed from 16 to 36 weeks of gestation. Results. At each measurement between 16 and 36 weeks of gestation, women with primary CMV infection who had a fetus or newborn with CMV disease had placentas that were significantly thicker than those of women with primary CMV infection who did not have a diseased fetus or newborn (P |
| doi_str_mv | 10.1086/507634 |
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Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. Methods. The study included 92 women with primary CMV infection during pregnancy and 73 CMV-seropositive pregnant women without primary CMV infection. Neonatal CMV transmission was determined by CMV culture of urine samples. Thirty-two women were treated with CMV hyperimmune globulin to either prevent or treat intrauterine CMV infection. Maximal placental thickness was measured by longitudinal (nonoblique) scanning with the ultrasound beam perpendicular to the chorial dish. Programmed placental ultrasound evaluations were performed from 16 to 36 weeks of gestation. Results. At each measurement between 16 and 36 weeks of gestation, women with primary CMV infection who had a fetus or newborn with CMV disease had placentas that were significantly thicker than those of women with primary CMV infection who did not have a diseased fetus or newborn (P <.0001); the latter group, in turn, had placentas that were significantly thicker than those of seropositive control subjects (P <.0001). For both women with and women without diseased fetuses or newborns, receipt of hyperimmune globulin after primary CMV infection was associated with statistically significant reductions in placental thickness (P <.001). Placental vertical thickness values, which are predictive of primary maternal infection, were observed at each measurement from 16 to 36 weeks of gestation, and cutoff values ranged from 22 mm to 35 mm, with the best sensitivity and specificity at 28 and 32 weeks of gestation. Conclusions. Primary maternal CMV infection and fetal or neonatal disease are associated with sonographically thickened placentas, which respond to administration of hyperimmune globulin. These observations suggest that many of the manifestations of fetal and neonatal disease are caused by placental insufficiency.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/507634</identifier><identifier>PMID: 16983610</identifier><language>eng</language><publisher>United States: The University of Chicago Press</publisher><subject>Adult ; Articles and Commentaries ; Cytomegalovirus ; Cytomegalovirus infections ; Cytomegalovirus Infections - diagnostic imaging ; Cytomegalovirus Infections - drug therapy ; Female ; Fetal diseases ; Fetal Diseases - prevention & control ; Fetal Diseases - virology ; Fetus ; Humans ; Immunoglobulins - therapeutic use ; Infant, Newborn ; Infant, Newborn, Diseases - prevention & control ; Infections ; Infectious Disease Transmission, Vertical - prevention & control ; Neonatal care ; Neonatal diseases ; Newborns ; Placenta ; Placenta - diagnostic imaging ; Placenta - virology ; Placenta Diseases - diagnostic imaging ; Placenta Diseases - drug therapy ; Placenta Diseases - virology ; Pregnancy ; Pregnancy Complications, Infectious - diagnostic imaging ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Complications, Infectious - virology ; Ultrasonography ; Ultrasonography, Prenatal ; Women</subject><ispartof>Clinical infectious diseases, 2006-10, Vol.43 (8), p.994-1000</ispartof><rights>Copyright 2006 The Infectious Diseases Society of America</rights><rights>Copyright University of Chicago, acting through its Press Oct 15, 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-60485bfd8ee7305822568ab9dd2610ae86c83c464eb129648f3beecb1ab5fc03</citedby><cites>FETCH-LOGICAL-c426t-60485bfd8ee7305822568ab9dd2610ae86c83c464eb129648f3beecb1ab5fc03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4485011$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4485011$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>315,781,785,804,27929,27930,58022,58255</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16983610$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>La Torre, Renato</creatorcontrib><creatorcontrib>Nigro, Giovanni</creatorcontrib><creatorcontrib>Mazzocco, Manuela</creatorcontrib><creatorcontrib>Best, Al M.</creatorcontrib><creatorcontrib>Adler, Stuart P.</creatorcontrib><title>Placental Enlargement in Women with Primary Maternal Cytomegalovirus Infection Is Associated with Fetal and Neonatal Disease</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>Background. Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. Methods. The study included 92 women with primary CMV infection during pregnancy and 73 CMV-seropositive pregnant women without primary CMV infection. Neonatal CMV transmission was determined by CMV culture of urine samples. Thirty-two women were treated with CMV hyperimmune globulin to either prevent or treat intrauterine CMV infection. Maximal placental thickness was measured by longitudinal (nonoblique) scanning with the ultrasound beam perpendicular to the chorial dish. Programmed placental ultrasound evaluations were performed from 16 to 36 weeks of gestation. Results. At each measurement between 16 and 36 weeks of gestation, women with primary CMV infection who had a fetus or newborn with CMV disease had placentas that were significantly thicker than those of women with primary CMV infection who did not have a diseased fetus or newborn (P <.0001); the latter group, in turn, had placentas that were significantly thicker than those of seropositive control subjects (P <.0001). For both women with and women without diseased fetuses or newborns, receipt of hyperimmune globulin after primary CMV infection was associated with statistically significant reductions in placental thickness (P <.001). Placental vertical thickness values, which are predictive of primary maternal infection, were observed at each measurement from 16 to 36 weeks of gestation, and cutoff values ranged from 22 mm to 35 mm, with the best sensitivity and specificity at 28 and 32 weeks of gestation. Conclusions. Primary maternal CMV infection and fetal or neonatal disease are associated with sonographically thickened placentas, which respond to administration of hyperimmune globulin. These observations suggest that many of the manifestations of fetal and neonatal disease are caused by placental insufficiency.</description><subject>Adult</subject><subject>Articles and Commentaries</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus infections</subject><subject>Cytomegalovirus Infections - diagnostic imaging</subject><subject>Cytomegalovirus Infections - drug therapy</subject><subject>Female</subject><subject>Fetal diseases</subject><subject>Fetal Diseases - prevention & control</subject><subject>Fetal Diseases - virology</subject><subject>Fetus</subject><subject>Humans</subject><subject>Immunoglobulins - therapeutic use</subject><subject>Infant, Newborn</subject><subject>Infant, Newborn, Diseases - prevention & control</subject><subject>Infections</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Neonatal care</subject><subject>Neonatal diseases</subject><subject>Newborns</subject><subject>Placenta</subject><subject>Placenta - diagnostic imaging</subject><subject>Placenta - virology</subject><subject>Placenta Diseases - diagnostic imaging</subject><subject>Placenta Diseases - drug therapy</subject><subject>Placenta Diseases - virology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - diagnostic imaging</subject><subject>Pregnancy Complications, Infectious - drug therapy</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Ultrasonography</subject><subject>Ultrasonography, Prenatal</subject><subject>Women</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhSMEog_gFyBksWAXsONnltXQTkcU6GIEFRvLcW6Kh4xdbKdQiR-PRxkVxIaV79X5fKR7TlU9I_g1wUq84VgKyh5Uh4RTWQvekodlxlzVTFF1UB2ltMGYEIX54-qAiFZRQfBh9etyNBZ8NiM69aOJ17AtG3IefQ5lQj9c_oouo9uaeIfemwzRF3Rxl4t6bcZw6-KU0MoPYLMLHq0SOkkpWFfQfv59Bjt343v0AYI3u-WtS2ASPKkeDWZM8HT_Hlfrs9P14ry--LhcLU4uassakWuBmeLd0CsASctJTcOFMl3b9025wYASVlHLBIOONK1gaqAdgO2I6fhgMT2uXs22NzF8nyBlvXXJwjgaD2FKWiglREPkf0HSSkIVawv48h9wE6ZdMkk3pG05F3-72RhSijDomzlHTbDelabn0gr4Yu82dVvo_2D7lgrwfAY2KYd4r7MSS6m0yPUsu5Th571s4jctJJVcn1990Wv5Ti3l1Se9pL8BSjSqFg</recordid><startdate>20061015</startdate><enddate>20061015</enddate><creator>La Torre, Renato</creator><creator>Nigro, Giovanni</creator><creator>Mazzocco, Manuela</creator><creator>Best, Al M.</creator><creator>Adler, Stuart P.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20061015</creationdate><title>Placental Enlargement in Women with Primary Maternal Cytomegalovirus Infection Is Associated with Fetal and Neonatal Disease</title><author>La Torre, Renato ; Nigro, Giovanni ; Mazzocco, Manuela ; Best, Al M. ; Adler, Stuart P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-60485bfd8ee7305822568ab9dd2610ae86c83c464eb129648f3beecb1ab5fc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Articles and Commentaries</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus infections</topic><topic>Cytomegalovirus Infections - diagnostic imaging</topic><topic>Cytomegalovirus Infections - drug therapy</topic><topic>Female</topic><topic>Fetal diseases</topic><topic>Fetal Diseases - prevention & control</topic><topic>Fetal Diseases - virology</topic><topic>Fetus</topic><topic>Humans</topic><topic>Immunoglobulins - therapeutic use</topic><topic>Infant, Newborn</topic><topic>Infant, Newborn, Diseases - prevention & control</topic><topic>Infections</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Neonatal care</topic><topic>Neonatal diseases</topic><topic>Newborns</topic><topic>Placenta</topic><topic>Placenta - diagnostic imaging</topic><topic>Placenta - virology</topic><topic>Placenta Diseases - diagnostic imaging</topic><topic>Placenta Diseases - drug therapy</topic><topic>Placenta Diseases - virology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - diagnostic imaging</topic><topic>Pregnancy Complications, Infectious - drug therapy</topic><topic>Pregnancy Complications, Infectious - virology</topic><topic>Ultrasonography</topic><topic>Ultrasonography, Prenatal</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>La Torre, Renato</creatorcontrib><creatorcontrib>Nigro, Giovanni</creatorcontrib><creatorcontrib>Mazzocco, Manuela</creatorcontrib><creatorcontrib>Best, Al M.</creatorcontrib><creatorcontrib>Adler, Stuart P.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>La Torre, Renato</au><au>Nigro, Giovanni</au><au>Mazzocco, Manuela</au><au>Best, Al M.</au><au>Adler, Stuart P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Placental Enlargement in Women with Primary Maternal Cytomegalovirus Infection Is Associated with Fetal and Neonatal Disease</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>2006-10-15</date><risdate>2006</risdate><volume>43</volume><issue>8</issue><spage>994</spage><epage>1000</epage><pages>994-1000</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Background. Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. Methods. The study included 92 women with primary CMV infection during pregnancy and 73 CMV-seropositive pregnant women without primary CMV infection. Neonatal CMV transmission was determined by CMV culture of urine samples. Thirty-two women were treated with CMV hyperimmune globulin to either prevent or treat intrauterine CMV infection. Maximal placental thickness was measured by longitudinal (nonoblique) scanning with the ultrasound beam perpendicular to the chorial dish. Programmed placental ultrasound evaluations were performed from 16 to 36 weeks of gestation. Results. At each measurement between 16 and 36 weeks of gestation, women with primary CMV infection who had a fetus or newborn with CMV disease had placentas that were significantly thicker than those of women with primary CMV infection who did not have a diseased fetus or newborn (P <.0001); the latter group, in turn, had placentas that were significantly thicker than those of seropositive control subjects (P <.0001). For both women with and women without diseased fetuses or newborns, receipt of hyperimmune globulin after primary CMV infection was associated with statistically significant reductions in placental thickness (P <.001). Placental vertical thickness values, which are predictive of primary maternal infection, were observed at each measurement from 16 to 36 weeks of gestation, and cutoff values ranged from 22 mm to 35 mm, with the best sensitivity and specificity at 28 and 32 weeks of gestation. Conclusions. Primary maternal CMV infection and fetal or neonatal disease are associated with sonographically thickened placentas, which respond to administration of hyperimmune globulin. These observations suggest that many of the manifestations of fetal and neonatal disease are caused by placental insufficiency.</abstract><cop>United States</cop><pub>The University of Chicago Press</pub><pmid>16983610</pmid><doi>10.1086/507634</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Articles and Commentaries Cytomegalovirus Cytomegalovirus infections Cytomegalovirus Infections - diagnostic imaging Cytomegalovirus Infections - drug therapy Female Fetal diseases Fetal Diseases - prevention & control Fetal Diseases - virology Fetus Humans Immunoglobulins - therapeutic use Infant, Newborn Infant, Newborn, Diseases - prevention & control Infections Infectious Disease Transmission, Vertical - prevention & control Neonatal care Neonatal diseases Newborns Placenta Placenta - diagnostic imaging Placenta - virology Placenta Diseases - diagnostic imaging Placenta Diseases - drug therapy Placenta Diseases - virology Pregnancy Pregnancy Complications, Infectious - diagnostic imaging Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - virology Ultrasonography Ultrasonography, Prenatal Women |
| title | Placental Enlargement in Women with Primary Maternal Cytomegalovirus Infection Is Associated with Fetal and Neonatal Disease |
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