Providing detailed hygiene advice reduced new primary maternal CMV infections by more than 75%, while treatments like valaciclovir and immunoglobulins may reduce transmission and neonatal symptoms.
Do antenatal interventions (hygiene advice, immunoglobulins, valaciclovir) prevent primary CMV infection and reduce maternal-fetal transmission or fetal effects?
Antenatal interventions including hygiene advice, immunoglobulins, and valaciclovir may help prevent primary CMV infection and reduce its long-term sequelae in neonates.
PURPOSE OF REVIEW: Cytomegalovirus (CMV) infection is by far the most common fetal viral infection. It carries a risk of long-term sequelae for the neonate; though the severity depends on the gestational age at the time of infection. Improvement in primary prevention of a CMV infection during pregnancy can be achieved by providing information regarding hygiene to the mother. Once a maternal infection occurs, treatment options include prevention of maternal-fetal transmission and, once transmission occurs, attempts to reduce the severity of its effect on the fetus. RECENT FINDINGS: Several recent studies have shown that providing detailed information regarding the effects of CMV on the fetus and providing common sense hygiene advice reduced new primary infections by more than 75%. In cases with a documented maternal primary CMV infection, treatment with intravenous immunoglobulins have been tried to reduce maternal fetal transmission with a variable degree of success. In the randomized controlled study of Revello et al., immunoglobulins did not reduce the transmission rate. In a recent study, immunoglobulins were given only to women with very recent first trimester infections. In this study, the transmission rate was 2.5%, which is significantly less than expected. Leruez-Ville et al. treated mothers with known transmission of CMV to the fetus with 8 g of valaciclovir daily. They observed a significant reduction in the number of neonatal symptoms in the treated cases. SUMMARY: Protocols are available to prevent primary CMV infections during pregnancy and, in cases where an infection does occur, steps can be taken to reduce its effect on the fetus thereby reducing the chance of long-term sequelae.
Kagan et al. (Fri,) conducted a review in Primary cytomegalovirus infections during pregnancy. Antenatal treatment options (hygiene advice, intravenous immunoglobulins, valaciclovir) was evaluated. Providing detailed hygiene advice reduced new primary maternal CMV infections by more than 75%, while treatments like valaciclovir and immunoglobulins may reduce transmission and neonatal symptoms.
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