Prenatal diagnosis of human cytomegalovirus by culture and polymerase chain reaction: 98 pregnancies leading to congenital infection

Human cytomegalovirus (HCMV) is the most common cause of viral intra-uterin e infection. The experience with prenatal diagnosis remains limited and is based on few reports of small numbers of cases. It is thus difficult to com pare the accuracy of the different tests because the groups studied were sm all and heterogeneous. We describe here our experience on a series of 98 pr egnancies leading to HCMV congenital infection, among which 71 have been te sted by amniotic fluid (AF) sampling followed by culture and/or polymerase chain reaction (PCR). Independently of the delay between AF sampling and th e first HCMV IgM positive result, the mean sensitivity of both culture and PCR was around 70 per cent. The best sensitivity (95.5 per cent) was obtain ed after a delay greater than or equal to 6 weeks in late pregnancy (greate r than or equal to 23 weeks). The present study demonstrated clearly that t he delay between AF puncture and the presumed date of seroconversion is mor e important for sensitivity than the technique used for the diagnosis (PCR or culture). However, even in the best diagnostic conditions, negative resu lts of HCMV culture or PCR in AF cannot formally exclude intra-uterine infe ction. Copyright (C) 1999 John Wiley & Sons, Ltd.