Introduction:
Any infection transmitted to a child from a pregnant mother is called a congenitally acquired infection. Several medical conditions show a transplacental transmission; one such kind with a wide prevalence is a cytomegalovirus (CMV) infection. CMV infection, though prevalent, has not gained much attention as such, as it goes unnoticed by many due to its symptomless nature. It is caused by a type of herpes virus. A thorough awareness of the ill effects and caution are essential factors in fighting this infection and saving infants from serious complications. Read further to know more about how this condition affects a pregnant mother and her offspring.
What Are the Must-Knowings About CMV Infection?
Cytomegalovirus infection is one of the commonly occurring conditions that affect people irrespective of their age, and it noticeably affects almost half of the people in their 40s. It is prevalent among all age groups. Once infected by this virus, there is no end to it; It can never be eradicated from the infected person's body and stays there for a lifetime. CMV does not make the person symptomatic or cause any harm unless the infected person is immunocompromised, like people with HIV, under immunosuppressive medications, or who have had organ transplants. If someone is immunocompromised, they may show symptoms such as CMV pneumonitis, CMV retinitis, CMV gastritis, and CMV encephalitis. This infection also can happen more than once, having different strains as the cause. CMV infection also tends to reactivate other illnesses that are dormant.
How Common Is CMV Infection in Pregnancy?
A pregnant woman usually would not even know of the underlying CMV infection until the baby's CMV reports are positive, as it often remains symptom-free throughout pregnancy. A CMV infection rarely shows symptoms; even if symptoms occur, they are similar to those in other medical conditions such asfever, throat problems, tiredness, lymph node enlargement, etc. But sometimes, when the mother is weak, there can be severe or fatal complications. It is also reported that around half of the women of childbearing age encounter CMV infection, and roughly one to four percent get it when pregnant.
How Does CMV Infection Affect a Pregnant Woman?
Cytomegalovirus infection could cause problems for the pregnant mother and the child. The common complications include the following:
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The delivery could happen preterm.
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The child could be born with a relatively low birth weight.
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The child could be born with a developmental anomaly or show a defect in later stages of life.
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Unfortunately,cytomegalovirusinfection can cause miscarriages in pregnant women as well.
When Does an Infant Get Infected With CMV?
An infant can get infected with cytomegalovirus anywhere before or after birth if the pregnant woman was infected with the virus before or during pregnancy.
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If the infection occurs in the mother's womb, it is called congenital CMV.
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If the newborn gets infected immediately after birth or while feeding on the mother's breast milk, it is called perinatal CMV.
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In the later stages, the infection gets reactivated or transmitted through factors such as a compromised or weak immune system, getting a blood transfusion, etc.
How Prevalent Is the CMV Transplacental Transmission?
When CMV has infected a pregnant mother, the mother's risk of infecting the child starts being a concern. Reports show that there have been around 40% of reported cases with transplacental transmission, whereas the rest has not demonstrated any transmission. However, the cause of transmission is still unknown. Also, the risk of transmission is more when the mother gets infected during pregnancy than when carrying the infection before getting pregnant.
What Are the Symptoms in a CMV-Infected Baby?
The signs that a baby shows at birth if infected by CMV include,
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Microcephaly (an abnormally small head).
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Anemia.
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Low birth weight.
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Hepatomegaly (enlarged liver).
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Splenomegaly (enlarged spleen).
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Seizures at birth.
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Jaundice(yellowish discoloration of skin, sclera (white part) of the eye, and mucus membranes).
The symptoms that might happen in later stages include the following;
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Hearing and vision loss.
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Frequent incidence of seizures.
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Delayed or lack of motor response and mental retardation results in symptoms such as lack of coordination and compromised intellectual capacity.
How Is CMV Infection Confirmed?
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Though tests are not advised periodically to rule out CMV infection in pregnant women, CMV IgG antibody testing is done when suspected. It rules out if the pregnant woman is infected with CMV or not.
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A second test called IgM antibody testing rules out if it is a current or a previously existing infection.
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Only if the first and the second tests come out positive, is a third test called the CMV IgG avidity index done to analyze if the infection is lesser or more than four months old. High and low levels of CMV IgG index represent more than four months old and less than four months old infection, respectively.
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CMV infection can be ruled out in a newborn by examining the body fluids such as urine, saliva, and blood. Testing for CMV infection in the urine is, however, considered the most reliable testing.
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Care should be taken that the baby is tested for CMV infection within the first three weeks at maximum since birth.
How Can CMV Infection Be Prevented?
CMV can be prevented from infecting a pregnant mother by avoiding contact with any of the body fluids of an infected person. The habits that need attention include; having sex with an infected partner and kissing, as CMV can pass through saliva. In babies, activities such as kissing should be avoided to prevent contracting CMV infection from an infected parent or a sibling.
How Is CMV Infection Treated?
Also, there is no proper treatment for CMV-infected pregnant mothers; the following treatment options have been considered;
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The mother should be administered intravenous CMV hyper immunoglobulin as prophylaxis or as treatment. Prophylactic dose prevents transmission to the fetus and minimizes the complications associated.
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Pregnancy termination has been considered an option as and when CMV infection is ruled out unless it is too late.
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Administering antiviral drugs could help settle the infection.
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In addition, ultrasounds are taken to analyze the fetal status.
The treatment in infants is based on how early the infection is ruled out. Earlier the treatment, the lesser the severity. Some minor cases settle down with proper care and rest. Whereas in others, children are prescribed antivirals to fight CMV infection. Taking antivirals at earlier stages decreases the risk of severe health complications and conditions like hearing loss. Also, children should be kept in check for hearing, as it is one of the significant complications of a CMV infection.
Conclusion:
CMV infection is often harmless and asymptomatic, even when pregnant. But, if affected with any other disease or having a weak immune system, there could be associated complications. Hence, keeping the immune system in check, staying away from any other health complications, and being cautious not to come in contact with an infected person play a significant role in protecting the pregnant mother and child from contracting the infection. Precaution helps avoid this viral infection.