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

被引：65

作者：

Guerra, Brunella ^{[1
]}

Simonazzi, Giuliana

Banfi, Alessandra

Lazzarotto, Tiziana

Farina, Antonio

Lanari, Marcello

Rizzo, Nicola

机构：

[1] Univ Bologna, St Orsola Malpighi Hosp, Sch Med, Dept Obstet & Gynecol, I-40126 Bologna, Italy

[2] Univ Bologna, St Orsola Malpighi Hosp, Sch Med, Dept Clin & Expt Med,Sect Microbiol, I-40126 Bologna, Italy

[3] La Scaletta Hosp, Dept Pediat & Neonatol, Imola, Italy

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2007年 / 196卷 / 03期

关键词：

confirmatory tests; cytomegalovirus; pregnancy terminations; prenatal counseling; screening;

D O I：

10.1016/j.ajog.2006.08.039

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

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 ≥ 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. © 2007 Mosby, Inc. All rights reserved.

引用

页码：221 / 223

页数：3

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