F. Mouly et al., PRENATAL-DIAGNOSIS SF FETAL VARICELLA-ZOSTER VIRUS-INFECTION WITH POLYMERASE CHAIN-REACTION OF AMNIOTIC-FLUID IN 107 CASES, American journal of obstetrics and gynecology, 177(4), 1997, pp. 894-898
OBJECTIVE: Varicella, resulting from primary infection by varicella zo
ster virus, carries a risk of severe congenital varicella. Prenatal di
agnosis is rarely applied because methods remain to be validated. STUD
Y DESIGN: From 1989 to 1994, 107 women contracted clinical varicella b
efore 24 weeks of pregnancy. Amniocentesis was performed in all cases,
with simultaneous fetal blood sampling in 82 cases, Virus was detecte
d in amniotic fluid by cell culture inoculation and polymerase chain r
eaction. Fetal blood was tested for anti-varicella tester virus immuno
globulin M. RESULTS: Of the 107 amniotic fluid samples tested, nine of
107 (8.4%) were positive by polymerase chain reaction, but only two o
f these (1.8%) were positive in cell culture; none of the blood sample
s from infected fetuses were positive for specific anti-varicella test
er Virus immunoglobulin M. The outcome of 99 pregnancies was fully doc
umented. CONCLUSION: The risk of transplacental passage before 24 week
s of pregnancy was 8.4% in our series. The risk of congenital varicell
a is 3 in 107 (2.8%) and that of isolated postnatal varicella tester i
nfection is 3 in 78 (3.8%). Polymerase chain reaction is more sensitiv
e than cell culture for the detection of varicella tester virus in amn
iotic fluid.