Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Am J Obstet Gynecol. 2007 Mar;196(3):221.e1-6.

Impact of diagnostic and confirmatory tests and prenatal counseling on the rate of pregnancy termination among women with positive cytomegalovirus immunoglobulin M antibody titers.

Author information

  • 1Department of Obstetrics and Gynecology, St Orsola Malpighi Hospital, University of Bologna School of Medicine, Bologna, Italy.

Abstract

OBJECTIVE:

The purpose of this study was to determine if diagnostic tests performed in a reference laboratory and the correct interpretation and communication of results by an expert physician to the patient can reduce the rate of unnecessary abortions among women with positive cytomegalovirus (CMV) immunoglobulin M antibody titers.

STUDY DESIGN:

This was a retrospective study of 1857 consecutive pregnant women with positive screening for IgM anti-CMV, in the first or second trimester of pregnancy, referred to our unit for further diagnostic evaluation. Patients with available follow-up were divided into 2 groups according to the results of confirmatory serologic testing: women with a CMV serologic profile suggestive of primary infection and hence at high risk of vertical transmission (group 1) and women with a CMV serologic profile consistent with nonprimary infection or past infection (group 2). The number of expected pregnancy terminations and the prevented fraction of abortions was calculated.

RESULTS:

Of 445 group 1 patients, 53 (11.9%) elected to terminate the pregnancy after being informed of the results of diagnostic tests; in contrast, only 5 (0.4%) women in group 2 underwent terminations (P < .001). At autopsy, 38 fetuses in group 1 proved infected. No information on fetal infection is available for pregnancies terminated in the first trimester (15 in group 1; 5 in group 2). We estimated that > or = 196 (11.9%) of all patients in groups 1 and 2 (n = 1650 patients) would have elected abortion on the basis of the positive result of screening for fetal CMV infection. After the results of confirmatory tests, only 58 women (53 in group 1 and 5 in group 2) elected to terminate the pregnancy. Thus, the number of abortions is presumed to have been decreased by 73% (P < .001).

CONCLUSION:

The correct interpretation and communication of confirmatory test results by expert physicians to pregnant women with positive screening for IgM anti-CMV may significantly reduce the rate of unnecessary abortions.

Comment in

PMID:
17346528
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk