Maternal IgG avidity, IgM and ultrasound abnormalities: combined method to detect congenital cytomegalovirus infection with sequelae

Objective:we used maternal immunoglobulin m (igm), immunoglobulin g (igg) avidity index (ai) and fetal ultrasonography (us) to effectively detect a congenital cytomegalovirus-infected fetus that would suffer neurological sequelae after birth.study design:the detecting method was prospectively adapted to 1163 unselected pregnant women. igm, igg and igg-ai were measured at the first prenatal examination (10.8±2.2 weeks of gestation). advanced us was performed for the igm-positive women at our center. the urine of 1163 neonates was examined via pcr. all infected neonates were followed for neurological development.result:most women (83.3%) were seropositive. among them, 40 (4.1%) were igm positive. nine of forty (22.5%) had low ai, of which one showed abnormal us and suffered severe sequelae. the remaining eight had a normal us; however, one infant had hearing impairment. there were another three infected infants with normal development. their mothers’ serological results were: igm positive with high ai (n=1); igg positive; igm negative with high ai (n=1); and both igg and igm negative (n=1).conclusion:this method enabled us to detect infected fetuses having severe sequelae. however, the problem remains of detecting infected fetuses that only have a hearing impairment.