Cytomegalovirus and pregnancy

Cytomegalovirus and pregnancy

Cytomegalovirus disease — a disease caused by a virus of the herpes family. Catch it, you will not get rid of it. Immunity to CMV is not generated! However it is possible to reduce the number of exacerbations of infection in the body.

The main source of cytomegalovirus infection is a sick man, who at the moment is the aggravation of the process. Cytomegalovirus transmission path is the same as that of the herpes virus (they belong to the same family), i.e.:

  • airborne,
  • sexual,
  • pin,
  • Fetal (trasnplatsentarny).

Cytomegalovirus during pregnancy

The danger of the virus to the body pregnant, especially for the fetus, is keen for cytomegalovirus infection, ie primary infection during pregnancy.

Infection from a human patient with acute cytomegalovirus infection — for pregnant women is the worst option, because because of absence of antibodies in the blood, unmitigated virus fairly easily crosses the placenta, damaging effect on the fetus (fetal infection occurs in40-50 % Of cases)

Exacerbation of latent virus infection under the influence of factors that weaken the immune system (eg, presence of comorbidities, medication, suppress the immune system), is a less dangerous situation. As to the fight against the virus entering the already existing antibodies (IgG, which were always hidden by virus infection), the virus becomes impaired, which reduces the degree of penetration of the placenta and attack the fetus (fetal infection occurs only in the1-2 % Of cases).

There is a definite relationship between the degree of adverse effects of the virus on the fetus and pregnancy. For example, during infection of the fetus in early pregnancy, there is a greater likelihood of miscarriage or abnormal development of the child.

When infected at a later date, fetal malformation is observed, but quite often there is polyhydramnios during pregnancy, premature birth, and marked the so-called "congenital cytomegalovirus" newborn.

Child with cytomegaly

For a child with a congenital cytomegaly characterized by jaundice, enlarged liver and spleen, decreased hemoglobin (anemia) and other changes in the blood, also marked, severe damage to the central nervous system, damage to the eyes and ears.

The discovery of the child IgG, in the first three months after birth, is not considered a sign of congenital cytomegalovirus, if his mother is a hidden place of virus, as These antibodies he got from his mother at birth and three months later they had gone on their own. Detection of a child IgM, is proof of the presence of acute cytomegalovirus infection.

What are the symptoms

The acute phase of CMV infection can occur in pregnant lungs influenza-like phenomena with a low temperature, malaise, which are fairly common, and for many other respiratory infections.

Diagnosis and prevention

After hitting the pathogen into the body, the body immediately begins to produce antibodies (immunoglobulins) for cytomegalovirus, which in most cases does not cause acute infection process and leads only to a latent (asymptomatic) virus infection, which is a long period of time can not show anything itself. Detection of antibodies to the definition of specific immunoglobulins IgM and IgG antibodies to CMV is the main method of detecting infection. For IgM in the blank laboratory findings is given a qualitative description of "positive" or "negative" for the IgG antibody titer results point (quantitative).

Immunoglobulin M(IgM) indicate a current infection — primary or recurrent. If the analysis indicated IgM — «positive», which means that there was a primary infection or transition latent (inactive) in the active infection, painful form, in which case it is possible intrauterine infection — you can not get pregnant. Therefore, it is necessary to determine the level of IgM quantitative method every 10-14 days to find out what stage the infection. A rapid drop in mean titers of IgM recent infection or worsening, slow indicates that the active phase of infection has passed.

If the analysis indicated IgM — "Negative" means that CMV infection occurred at least 1 month prior to diagnosis, however, does not exclude the transition from latent infection in the active stage. In this case, intrauterine infection is unlikely.

Immunoglobulin G (IgG) as detected by a latent CMV infection during and at its exacerbation or primary infection. The excess of the values specified in the blank lab means CMV infection. Can intrauterine infection, but the probability of its occurrence is unknown.

If IgG titers are within the range specified in the form Laboratories, this means that CMV infection is detected or infection occurred during the previous 3 — 4 weeks. Intrauterine infection is not possible, except in cases of simultaneous presence of IgM.

If a person has never been infected with CMV, the IgG titer is below the value specified on the form of the analysis. This is a very high probability of infection by cytomegalovirus during pregnancy. Women who do not have a titer IgG, are at risk.

After primary infection with CMV IgG antibodies remain in the blood for life. The transition of cytomegalovirus infection from latent to active against a weakened immune possible pregnancy and the presence of IgG. After the initial infection or activation of infection are rising IgG titers (an increase of 4 or more times the starting level), and then very slowly falling.

The probability of infection of the fetus.

The probability of infection of the fetus depends on the concentration of virus in the blood. A virus concentration is determined by the level of protective antibodies: more than antibodies, the lower the concentration of virus. People newly infected with CMV antibodies are not present, so the concentration of the virus is very high, therefore, infection of the fetus is most likely. Carriers have cytomegalovirus antibody, so the concentration of virus in the blood below.

Prevention of transmission of infection and CMV infection is to isolate patients with the acute stage of the process, both the newborn and from pregnant women.

Like this post? Please share to your friends: