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Abstract：
To define the predictive value (PV) of known prognostic factors of fetal infection with Cytomegalovirus following maternal primary infection <14 weeks of gestation, at different time points of pregnancy: the end of the second trimester; following prenatal magnetic resonance imaging (MRI) at 32 weeks of gestation; and using all ultrasound scans performed in the third trimester (US3rdT).
A retrospective study.
Reference fetal medicine unit.
Sixty-two fetuses infected <14 weeks of gestation.
We defined second-trimester assessment (STA) as the combination of ultrasound findings <28 weeks of gestation and fetal platelet count at cordocentesis. Three groups were defined: normal, extracerebral, and cerebral STA.
For each group, the PV of STA alone, STA + MRI, and STA + US3rdT were assessed retrospectively. Outcome at birth and at follow-up were reported.
The STA was normal, and with extracerebral and cerebral features, in 43.5, 42.0, and 14.5%, respectively. The negative PV of normal STA and MRI for moderate to severe sequelae was 100%. The residual risk was unilateral hearing loss in 16.7% of cases. Of pregnancies with cerebral STA, 44% were terminated. Following extracerebral STA, 48% of neonates were symptomatic and 30% had moderate to severe sequelae. In those cases, the positive and negative PV of MRI for sequelae were 33 and 73%, respectively. STA + US3rdT had a lower negative PV than MRI for symptoms at birth and for moderate to severe sequelae. Any false-positive findings at MRI were mostly the result of hypersignals of white matter.
Serial assessment in the second and third trimesters by ultrasound and MRI is necessary to predict the risk of sequelae occurring in 35% of pregnancies following fetal infection in the first trimester of pregnancy.
Serial ultrasound prognostic assessment following fetal CMV infection in the 1st trimester is improved by MRI at 32 weeks.
A retrospective study.
Reference fetal medicine unit.
Sixty-two fetuses infected <14 weeks of gestation.
We defined second-trimester assessment (STA) as the combination of ultrasound findings <28 weeks of gestation and fetal platelet count at cordocentesis. Three groups were defined: normal, extracerebral, and cerebral STA.
For each group, the PV of STA alone, STA + MRI, and STA + US3rdT were assessed retrospectively. Outcome at birth and at follow-up were reported.
The STA was normal, and with extracerebral and cerebral features, in 43.5, 42.0, and 14.5%, respectively. The negative PV of normal STA and MRI for moderate to severe sequelae was 100%. The residual risk was unilateral hearing loss in 16.7% of cases. Of pregnancies with cerebral STA, 44% were terminated. Following extracerebral STA, 48% of neonates were symptomatic and 30% had moderate to severe sequelae. In those cases, the positive and negative PV of MRI for sequelae were 33 and 73%, respectively. STA + US3rdT had a lower negative PV than MRI for symptoms at birth and for moderate to severe sequelae. Any false-positive findings at MRI were mostly the result of hypersignals of white matter.
Serial assessment in the second and third trimesters by ultrasound and MRI is necessary to predict the risk of sequelae occurring in 35% of pregnancies following fetal infection in the first trimester of pregnancy.
Serial ultrasound prognostic assessment following fetal CMV infection in the 1st trimester is improved by MRI at 32 weeks.
摘要：
定义孕妇原发感染<14孕周后胎儿巨细胞病毒感染的已知预后因素的预测价值（PV）。在不同的妊娠时间点：妊娠中期结束；在妊娠32周时进行产前磁共振成像（MRI）；并使用妊娠中期进行的所有超声扫描（US3rdT）。
一项回顾性研究。
胎儿医学参考单元。
62例胎儿在妊娠<14周感染。
我们将孕中期评估（STA）定义为妊娠28周以下的超声检查结果和宫腔穿刺术中的胎儿血小板计数的组合。定义了三组：正常，脑外,和大脑STA。
对于每个组，仅STA的PV，STA+MRI,和STA+US3rdT进行回顾性评估。报告了出生时和随访时的结果。
STA正常,具有脑外和大脑特征，在43.5、42.0和14.5%中，分别。正常STA和中重度后遗症MRI的PV阴性为100％。16.7%的病例的残余风险为单侧听力损失。患有大脑STA的怀孕，44%被终止。脑外STA后，48％的新生儿有症状，30％的新生儿有中度至重度后遗症。在这些情况下,后遗症的MRI阳性和阴性PV分别为33％和73％，分别。对于出生时的症状和中度至重度后遗症，STAUS3rdT的阴性PV低于MRI。MRI的任何假阳性发现大多是白质超信号的结果。
在妊娠中期和中期，通过超声和MRI进行连续评估对于预测妊娠早期胎儿感染后35%的妊娠发生后遗症的风险是必要的。
第32周的MRI改善了妊娠早期CMV感染后的连续超声预后评估。
一项回顾性研究。
胎儿医学参考单元。
62例胎儿在妊娠<14周感染。
我们将孕中期评估（STA）定义为妊娠28周以下的超声检查结果和宫腔穿刺术中的胎儿血小板计数的组合。定义了三组：正常，脑外,和大脑STA。
对于每个组，仅STA的PV，STA+MRI,和STA+US3rdT进行回顾性评估。报告了出生时和随访时的结果。
STA正常,具有脑外和大脑特征，在43.5、42.0和14.5%中，分别。正常STA和中重度后遗症MRI的PV阴性为100％。16.7%的病例的残余风险为单侧听力损失。患有大脑STA的怀孕，44%被终止。脑外STA后，48％的新生儿有症状，30％的新生儿有中度至重度后遗症。在这些情况下,后遗症的MRI阳性和阴性PV分别为33％和73％，分别。对于出生时的症状和中度至重度后遗症，STAUS3rdT的阴性PV低于MRI。MRI的任何假阳性发现大多是白质超信号的结果。
在妊娠中期和中期，通过超声和MRI进行连续评估对于预测妊娠早期胎儿感染后35%的妊娠发生后遗症的风险是必要的。
第32周的MRI改善了妊娠早期CMV感染后的连续超声预后评估。
