Introduction:
The objectives were: 1. to present our preliminary experience in sixteen pregnant women undergoing a prenatal evaluation to assess for fetal infection; 2. to estimate the reliability of CMV-specific IgM as an indicator of fetal infection using polymerase chain reaction (PCR) for amplification of DNA. Patients: Sixteen patients were referred for prenatal diagnosis of suspected fetal cytomegalovirus infection (CMV). Two women had documented positive IgG and IgM(one with IgA positive) immunoglobulin titres in the first trimester of pregnancy and two in the second trimester. Twelve patients were evaluated because of abnormal ultrasonographic examinations under suspicion of fetal infection. Methods: Mothers serum was assayed for the presence of CMV-specific IgM by an enzyme-linked immunoabsorbent assay (ELISA). Four methods of fetal diagnosis were employed involving a combination of amniocentesis, fetal blood sampling, prenatal paracentesis and thoracentesis. Six fetuses underwent fetal intervention at a median gestational age (range 28 to 30 weeks). Five out of sixteen cases had bilateral pleural effusions and hydrops. DNA was extracted from cultures of mothers blood and urine, amniotic fluid, fetal cord blood, pleural effusions and ascetic fluid. For the detection of CMV DNA in DNA preparations the nested-PCR test constructed in the Center of Microbiology and Virology PAS and PCR based TaKaRa (Japan) Human Cytomegalovirus infection was used. Results: Out of twelve patients evaluated because of abnormal ultrasonographic examinations suspective fetal CMV infection serological methods (positive IgG and negative IgM) in three cases DNA studies confirmed the presence of fetal CMV infection. Out of four patients with positive serological tests in one case with positive IgG, IgM and IgA DNA studies documented the presence of fetal infection and in three patients results suggested most likely a false-positive IgM.