Gebelikte ve Konjenital Sitomegalovirüs Enfeksiyonu
Synopsis
Human cytomegalovirus (CMV) is one of the most common causes of congenital viral infection. Although maternal infection is usually asymptomatic, transplacental transmission may result in sensorineural hearing loss, visual impairment, and neurodevelopmental sequelae. This chapter reviews the epidemiology and transmission of CMV, the natural history of maternal and fetal infection, laboratory diagnosis, and current management approaches. It emphasizes that CMV IgM positivity alone is insufficient for diagnosing primary maternal infection and should be interpreted together with IgG seroconversion and IgG avidity testing. Detection of CMV DNA in appropriately timed amniotic fluid samples by polymerase chain reaction is the principal method for prenatal diagnosis of fetal infection. Ultrasonography and fetal magnetic resonance imaging contribute to prognostic assessment. Current evidence and differences between guidelines regarding antenatal valaciclovir and CMV hyperimmune globulin are discussed. Congenital infection should be confirmed by detecting CMV DNA in saliva or urine within the first 21 days of life. Antiviral treatment, audiological follow-up, newborn screening strategies, and preventive measures are also addressed.
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