Predicting Outcome of Congenital Cytomegalovirus Infection by Differentiating and Revisiting Severe versus Mild Prenatal Imaging Features.


Journal

Fetal diagnosis and therapy
ISSN: 1421-9964
Titre abrégé: Fetal Diagn Ther
Pays: Switzerland
ID NLM: 9107463

Informations de publication

Date de publication:
2023
Historique:
received: 31 12 2021
accepted: 26 10 2022
medline: 31 8 2023
pubmed: 25 1 2023
entrez: 24 1 2023
Statut: ppublish

Résumé

Our objective was to evaluate the outcome of fetuses with first- and second-trimester fetal cytomegalovirus infection (CMVi) according to prenatal imaging patterns, especially fetuses presenting with mild imaging features (MF), being currently of uncertain prognosis. In a retrospective study of 415 suspected CMVi cases, 59 cases were confirmed. Among prenatal imaging features, microcephaly, cortical disorder, and cerebellar hypoplasia as well as severe IUGR and fetal hydrops were considered as severe imaging features (SF). Other imaging features were considered as MF. Postnatal outcome was classified as "normal outcome," "mild sequelae" characterized mainly by sensorineural disorder (SND) and "severe sequelae" characterized by cognitive impairment. Only first-trimester (T1) and second-trimester (T2) CMVi cases were included in our study (n = 49) since all third-trimester cases (n = 10) had normal imaging and outcome. Sixteen fetuses had normal prenatal imaging and normal outcome, except one showing SND. Abnormal ultrasound findings were present in 33 fetuses, including SF noted in 16 fetuses, related exclusively to first-trimester CMVi. Termination of pregnancy was performed in 18 cases. Twelve first-trimester infected fetuses presented SF, whereas 6 fetuses (T1: n = 5, T2: n = 1) presented isolated MF. Four fetal deaths were encountered. Live-born babies with abnormal imaging included 10 fetuses with MF and one with SF. Among the 10 live babies with isolated MF, SND was encountered in 5 cases, whereas 5 children demonstrated normal outcome. Overall, 50% of our babies showing MF suffered from SND. No case of cognitive disorders was reported in babies showing only MF. SF were encountered only in first-trimester CMVi and should be distinguished from MF. Among our 10 live babies with prenatal MF following first- or second-trimester infection, 50% showed SND, whereas none presented severe sequelae. In 16 fetuses displaying normal fetal imaging, SND was encountered in one first-trimester case (6%).

Identifiants

pubmed: 36693325
pii: 000527921
doi: 10.1159/000527921
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

143-157

Informations de copyright

© 2023 S. Karger AG, Basel.

Auteurs

Mona Massoud (M)

Centre Pluridisciplinaire de Diagnostic Prénatal Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France, mona.massoud@chu-lyon.fr.

Maude Chollet (M)

Centre Pluridisciplinaire de Diagnostic Prénatal Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France.

Sara Cabet (S)

Centre Pluridisciplinaire de Diagnostic Prénatal Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France.
Imagerie pédiatrique et fœtale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Villeurbanne, France.

Marine Butin (M)

Service de Néonatologie Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France.

Yahia Mekki (Y)

Département de virologie, Service de Biologie Groupement Hospitalier Est, Lyon-Bron, France.

Geneviève Lina-Granade (G)

Service d'ORL pédiatrique, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France.

Axel Fichez (A)

Centre Pluridisciplinaire de Diagnostic Prénatal Hôpital de la Croix-Rousse, Université Claude Bernard Lyon 1, Villeurbanne, France.

Jocelyne Attia (J)

Centre Pluridisciplinaire de Diagnostic Prénatal Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France.

Dorothée Ville (D)

Service de neurologique pédiatrique, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France.

Laurent Guibaud (L)

Centre Pluridisciplinaire de Diagnostic Prénatal Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France.
Imagerie pédiatrique et fœtale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Villeurbanne, France.

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Classifications MeSH