Ultrasonographic Signs of Cytomegalovirus Infection in the Fetus—A Systematic Review of the Literature

Abstract

Background: congenital cytomegalovirus (cCMV) infection during pregnancy is a significant risk factor for fetal and neonatal morbidity and mortality. CMV detection is based on the traditional ultrasound (US) and MRI (magnetic resonance) approach. Methods: the present review used the PRISMA protocol for identification of studies associated with CMV infection and sonographic analysis. Various search terms were created using keywords which were used to identify references from Medline, Pubmed, PsycInfo, Scopus and Web of Science. Results: sonographic analysis of the cCMV infection identified several of the key features associated with fetuses. The presence of abnormal patterns of periventricular echogenicity, ventriculomegaly and intraparenchymal calcifications is indicative of CMV infection in the fetus. Hyperechogenic bowels were seen frequently. These results correlate well with MRI data, especially when targeted transvaginal fetal neurosonography was carried out. Conclusions: ultrasonography is a reliable indicator of fetal anomalies, due to cCMV. Fetal brain and organ changes are conclusive indications of infection, but many of the ultrasonographic signs of fetal abnormality could be due to any viral infections; thus, further research is needed to demarcate CMV infection from others, based on the ultrasonographic approach. CMV infection should always be an indication for targeted fetal neurosonography, optimally by the transvaginal approach.

Cytomegalovirus and Pregnancy: A Narrative Review

“…The abnormalities seen on MRI are the same as those seen on ultrasound, but with a different incidence, with the most common abnormalities seen on MRI being temporal cysts and lesions in the brain parenchyma [25]. (Figure 3) It is known that the additional findings on MRI are due to the lack of studies using multiplanar neurosonography performed by an experienced professional, because when this is method is used, the results of both types of imaging are similar [26,27]. Intrauterine CMV infection is an indication for multiplanar (transvaginal) neurosonography [27].…”

“…(Figure 3) It is known that the additional findings on MRI are due to the lack of studies using multiplanar neurosonography performed by an experienced professional, because when this is method is used, the results of both types of imaging are similar [26,27]. Intrauterine CMV infection is an indication for multiplanar (transvaginal) neurosonography [27]. The main changes seen on neurosonography are abnormal patterns of periventricular echogenicity (suggesting periventriculitis), ventriculomegaly, and echogenic focus in the brain parenchyma [27].…”

“…Intrauterine CMV infection is an indication for multiplanar (transvaginal) neurosonography [27]. The main changes seen on neurosonography are abnormal patterns of periventricular echogenicity (suggesting periventriculitis), ventriculomegaly, and echogenic focus in the brain parenchyma [27]. The absence of CNS ultrasound and MRI abnormalities during prenatal care is an important prognostic factor, as a very small percentage of newborns are symptomatic (1.5%) or have abnormal neurodevelopment (3.1%) or hearing loss (up to 11.4%) [26].…”

The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women

“…The main concern is whether a primary CMV infection occurs in pregnant women, because the virus could pass through the placenta and affect the fetus, causing disabilities such as hearing or vision loss, intellectual and neuronal impairment, etc. [9]. Although antiviral therapy and specific immunoglobulins have been tested to reduce the risk of fetal damage, the best prevention is reducing the risk of infection [10,11].…”

Awareness of Pregnant Patients about Congenital Cytomegalovirus Infection—A Semi-Systematic Review

“…SNHL is observed in approximately 10.7-32.4% of all children diagnosed with congenital CMV (cCMV) [7]. Other complications include several ophthalmologic manifestations, developmental delays, and neuroimaging abnormalities [8][9][10]. Furthermore, these possible sequelae necessitate prolonged medical observation and various therapeutic interventions.…”