Cytomegalovirus infection in a pregnant woman can cause deformities in the fetus if it is infected. This is why it is important to know if you are at risk of contracting this disease and to protect yourself with hygiene rules if this is the case.

Cytomegalovirus is a virus of the herpesvirus family (Herpesviridae). It is contaminated by contact with saliva, tears or urine, or genital secretions, but also by projections during coughing. This virus occurs most often during childhood.

Cytomegalovirus infection is the most common maternal-fetal viral infection.

A majority of pregnant women have had cytomegalovirus infection during childhood. They present antibodies against the virus. They can reactivate the virus during pregnancy but the risk of transmission to the fetus is very low. For other mothers-to-be, this virus represents a danger if it occurs for the first time (primary infection) during the first trimester of pregnancy and up to 27 weeks of amenorrhea (27 WA or 25 weeks of pregnancy). In the case of primary infection of the mother, the contamination is transmitted through the blood to the fetus in half of the cases. Cytomegalovirus can cause developmental delay, brain deformities, or deafness, but most babies with congenital cytomegalovirus infection have no symptoms when they are born. However, a small number of babies born unharmed may develop sensorineural sequelae before the age of 2 years.

Cytomegalovirus: what is your immunological status?

A blood test taken at the beginning of pregnancy allows to know the immunological status with regard to cytomegalovirus. If the serodiagnosis shows an absence of antibodies, you must follow hygienic conditions during your pregnancy to avoid cytomegalovirus.

Gynecologists also have serodiagnoses done during pregnancy to see if the pregnant woman has not had a cytomegalovirus infection. If so, they can set up fetal monitoring. Routine screening for cytomegalovirus infections during pregnancy is, however, not recommended by public health authorities. There is in fact no treatment and health professionals also fear overdiagnosis and excessive recourse to voluntary or medical termination of pregnancy. Serologic screening for CMV is recommended in women who develop flu-like symptoms during pregnancy or after ultrasound signs suggestive of CMV infection.

CMV infection in an adult often does not give any symptoms, but CMV can give a viral syndrome that resembles the flu. Main symptoms: fever, headache, severe fatigue, nasopharyngitis, lymph nodes, etc.

Did you have a cytomegalovirus infection before 27 weeks? To find out if your fetus is affected, ultrasound monitoring is set up. A sample of amniotic fluid (amniocentesis) can be taken from 22 weeks in order to know if the virus is present in the amniotic fluid.

If the ultrasound is normal and the amniotic fluid does not contain the virus, it is reassuring! However, ultrasound monitoring will take place throughout the pregnancy and the baby will be screened for CMV at birth.

If the ultrasound shows an abnormality suggestive of CMV infection (growth retardation, hydrocephalus (accumulation of fluid inside the skull) and the virus is present in the amniotic fluid, the fetus has severe damage. medical termination of pregnancy (IMG) may be offered to you.

If the virus is present in the amniotic fluid but the normal ultrasound, it is not possible to know whether the fetus has been infected or not. Pregnancy can continue with ultrasound monitoring.

To protect your baby in utero, it is important to minimize the risk of contracting cytomegalovirus if you are at risk. Since cytomegalovirus is often transmitted by children under 3 years of age, if you come into contact with young children during your pregnancy (either your own or during your work) be sure to wash your hands thoroughly after changing. diapers or wiped off secretions and do not share your cutlery with them. It is also advisable not to kiss young children on the mouth.

Prevention and treatment of cytomegalovirus in utero?

Two treatments for congenital CMV infection are currently under study:

• antiretroviral therapy
• a treatment which consists of injecting specific anti-CMV immunoglobulins

The objective of these treatments is to decrease the rate of transmission to the fetus in the event of maternal infection and to decrease the rate of sequelae in the event of fetal infection.

A CMV vaccine that could be given in early pregnancy to women who are HIV negative for CMV infection is also being investigated.