Chiara Puccetti

Ultrasound prediction of symptomatic congenital cytomegalovirus infection

OBJECTIVE The objective of the study was to assess the effectiveness of ultrasound in the antenatal prediction of symptomatic congenital cytomegalovirus (CMV) infection. STUDY DESIGN The sonograms of 650 fetuses from mothers with primary CMV infection were correlated to fetal or neonatal outcome. Infection status was disclosed by viral urine isolation at birth or CMV tissue inclusions at autopsy. Classification of symptomatic disease was based on postnatal clinical or laboratory findings or macroscopic evidence of tissue damage at autopsy. RESULTS Ultrasound abnormalities were found in 51 of 600 mothers with primary infection (8.5%) and 23 of 154 congenitally infected fetuses (14.9%). Symptomatic congenital infection resulted in 1 of 23 and 68 of 131 cases with or without abnormal sonographic findings, respectively. Positive predictive values of ultrasound vs symptomatic congenital infection was 35.3% relating to all fetuses or infants from mothers with primary infection and 78.3% relating to fetuses or infants with congenital infection. CONCLUSION When fetal infection status is unknown, ultrasound abnormalities predict symptomatic congenital infection in only a third of cases.

Parvovirus B19 in pregnancy: possible consequences of vertical transmission

The aim was to determine the outcome of pregnancies complicated by maternal Parvovirus B19 (B19) infection.

P01.03: Maternal primary cytomegalovirus infection and small for gestational age neonates

Two placentas in singleton pregnancy with fused umbilical cord which has its own placental insertion site forming 3-vessel cord at fetal end is an extremely rare case. This present case describes two placentas with fused umbilical cord with an episode of vanishing twin syndrome and there seems to be a strong relationship between these two events. Therefore, as far as we know, this is the first case in the world which describes two placentas with fused umbilical cord related to vanishing twin syndrome. A 37-year-old woman, gravid 0, para 0, visited ER with an episode of vaginal bleeding without pelvic cramps at 8 weeks and 5 days of gestation and repeated ultrasonic exams revealed reabsorption of vanishing twin and two separate placentas on anterior and posterior body of uterus. At 40 weeks and 4 days, the patient delivered a viable female infant weighing 3900 g via Cesarean section and postpartum examination of the placentas and membranes confirmed two placentas with fused umbilical cord. Two placentas were almost equal in size and main placental disc cord had 2 arteries with one vein (3 vessel-cord) whereas side placental disc cord had one artery with one vein (2 vessel-cord). Several hypothesis including placenta abnormalities after IVF-ET procedure, succenturiate lobes and fetus-in-fetu were proposed.

OP27.09: Parvovirus B19 in pregnancy: possible consequence of vertical transmission

not require blood transfusions. Minimal platelet count values after exchange or supplement transfusions were: mean 126 G/L, (11 ± 426). Thrombocytopenia (< 150 G/L) occurred in 25% of neonates immediately after delivery and in 75% after exchange or supplement transfusions. Intracranial II◦ hemorrhages were observed in 7 neonates (25%) and I◦ hemorrhages in 4 neonates (14%). Conclusions: Multiply intrauterine transfusions in isoimmunised fetuses do not increase the incidence of induced thrombocytopenia in newborns immediately after delivery. It occurs in newborns after exchange and/or supplement transfusions with minimum PLT count values reaching 11 G/L. These newborns seem to be at higher risk of intracranial hemorrhages although studies on numerous groups of patients are recommended.