DETECTION OF INTRAUTERINE VIRAL-INFECTION USING THE POLYMERASE-CHAIN-REACTION

Intrauterine viral infection commonly presents as nonimmune hydrops fe talis or intrauterine growth restriction. Cytomegalovirus (CMV) and pa rvovirus are commonly recognized causes of fetal infection using serol ogy and cultures. We used the polymerase chain reaction (PCR) to evalu ate the frequency of fetal viral infection and the associated clinical course and outcome. Specimens (amniotic fluid, fetal blood, pleural f luid, tissue) from 303 abnormal pregnancies at risk for viral infectio n and 154 controls were analyzed using primers for CMV, herpes simplex virus, parvovirus B19, adenovirus, enterovirus, Epstein-Barr virus, a nd respiratory syncytial virus. Viral genome was detected in 144/371 s amples (39%) or 124/303 patients (41%), with adenovirus (n = 74 patien ts; 24%), CMV (n = 30 patients; 10%), and enterovirus (n = 22 patients ; 7%) most common. Only 4/154 (2.6%), unaffected control patients' sam ples were PCR positive. We conclude that diagnosis of fetal viral infe ction by PCR is common in abnormal pregnancies. Adenovirus and enterov irus may cause fetal infection that have been previously unrecognized. (C) 1998 Academic Press.