ELEVATED MATERNAL SERUM AND AMNIOTIC-FLUID ALPHA-FETOPROTEIN ASSOCIATED WITH IN-UTERO CYTOMEGALOVIRUS-INFECTION

Objective: We report a unique case of congenital cytomegalovirus infec tion characterized by both elevated maternal serum and amniotic fluid a-fetoprotein (MSAFP and AFAFP). Methods/Results: Amniotic fluid cultu re and fetal blood analysis diagnosed cytomegalovirus infection in a h ydropic and growth-impaired 22-week fetus. The MSAFP was 4.37 MOM, and the AFAFP was 6.72 MOM. AF acetylcholinesterase and fetal hemoglobin were absent. No congenital anomalies were present. A neonatal urine cu lture positive for cytomegalovirus confirmed the prenatal diagnosis. C onclusion: In utero cytomegalovirus infection should be considered in the differential diagnosis of elevated MSAFP, especially if the AFAFP is also inexplicably elevated. MSAFP and AFAFP levels may be reasonabl e to study for determining the prognosis for cases of in utero cytomeg alovirus infection.