Important information about CMV for OB/GYNs
There is a prominent health threat in our nation that is slipping under the radar: CMV. Each year, a startling 1 in 150 children is born with this congenital infection, compared to 1 in 733 that will be born with Down Syndrome. And while most everyone knows about Down Syndrome, only 14% of women have heard of CMV. With your help, we can raise awareness and empower pregnant women, protecting their babies through simple prevention methods and giving them options for treatment if they do contract this virus.
Important information about CMV for OB/GYNs
Which of my patients are at risk for CMV?
In the United States, about 50 to 60% of women are at risk for contracting CMV infection during pregnancy. CMV poses a major risk to pregnant women, especially mothers, daycare workers, preschool teachers, therapists, and nurses. Pregnant women who have young children, are around young children, or work with young children should be especially careful and should be educated about the risks of CMV and the precautions they can take to prevent infection.
Should I be telling my pregnant patients about CMV?
Yes. The American College of Obstetricians and Gynecologists (ACOG) and the CDC recommend that OB/GYNs counsel women on basic prevention measures to guard against CMV infection. But according to a 2007 survey, fewer than half (44%) of OB/GYNs reported counseling their patients about preventing CMV. This could be due to the perceived rarity of congenital CMV cases, the lack of congenital CMV diagnoses within their practice, or just a simple oversight.
National CMV understands how difficult it may be to adjust one's daily routine while pregnant, especially for mothers and those women who work as child care providers, daycare workers, nurses, teachers, and therapists. However, it is important for these messages to be communicated to pregnant women and those planning future pregnancies in order to inform and empower them to take a more active role in their personal hygiene and healthcare decisions.
Print CMV awareness flyers for your practice and patients by clicking here.
What do I need to tell my patients about CMV?
CMV is very common among healthy children 1 to 3 years of age who are at high risk for contracting CMV from their peers. Considering that CMV is present in saliva, urine, tears, blood, mucus, and other bodily fluids, frequent handwashing with soap and water is important after contact with diapers or oral secretions. This is especially important if a woman is around a child who is in daycare, playgroup, or interacting with other young children on a regular basis.
Here are a few simple steps a woman can take to avoid exposure to saliva and urine that might contain CMV:
* Wash your hands often with soap and water for 15-20 seconds, especially after changing diapers, feeding a young child, wiping a young child's nose or drool, and handling children's toys
* Do not share food, drinks, or eating utensils used by young children
* Do not put a child's pacifier in your mouth
* Do not share a toothbrush with a young child
* Avoid contact with saliva when kissing a child
* Clean toys, countertops, and other surfaces that come into contact with children's urine or saliva
When do I need to test for CMV?
The CDC does not recommend routine maternal screening for CMV infection during pregnancy because there is no test that can definitively rule out primary CMV infection during pregnancy.
But most pregnant women don't realize that they have been infected with CMV because, usually, CMV produces no obvious symptoms and. Symptoms of CMV infection can be similar to those of mononucleosis. Symptoms of CMV infection in a pregnant woman may include the following:
* High fever
* General discomfort, uneasiness, or ill feeling
* Joint stiffness
* Muscle aches or joint pain
* Night sweats
* Prolonged fever
* Sore throat
* Swelling of the lymph nodes
* Loss of appetite
* Weight loss
Occasionally, the need for CMV testing arises when abnormalities that may be caused by CMV or other infectious diseases are seen on ultrasound. If one or more of the following signs are identified via ultrasound, an amniocentesis should be done to confirm a congenital CMV infection via TORCH testing:
* Placental thickening
* Fetal hydrops
* Abnormality of amniotic fluid
* Cerebral ventriculomegaly
* Intracranial calcifications
* Hyperdense image in thalamic arteries
* Periventricular echodensities
* Hepatic echodensities
* Intestinal echodensities
* Cystic structures in the germinal zone
Are there any treatments for CMV?
Yes. Recent studies indicate that CMV hyperimmune globulin treatment may reduce the risk of congenital infection and/or neonatal disease when given to pregnant women experiencing a primary CMV infection.
What symptoms at birth would indicate congenital CMV infection?
An infant should be immediately tested for congenital CMV if they manifest any of the following signs:
* Petechiae (purpura)
* Jaundice of unknown etiology
* Microcephaly of unknown etiology
* Small size at birth/IUGR
* Premature birth of unknown etiology
* Liver problems
* Spleen problems
* Lung problems
* Bleeding problems
* Growth problems
* Hearing loss
* Vision loss
* Mental disability
(Note: If a newborn does NOT show any of the following signs at birth, it does not mean they cannot be diagnosed with congenital CMV.)
Category: Awareness, "Basic Facts", Clinical, Recommendations