We report three autopsy cases of congenital cytomegalovirus (CMV) infection
in fetuses with a review of literature. The clinical manifestations in the
se cases of congenital CMV infection include intrauterine fetal death, hydr
ops fetalis, and CMV pneumonia associated with cardiovascular defect. The p
athological characteristics were as follows: 1) the kidney was the most fre
quently involved organ, followed by lung and liver, 2) CMV inclusions were
found predominantly in epithelial cells and to a lesser degree in endotheli
al cells, 3) intrahepatic bile duct epithelial cells were frequently involv
ed, and 4) inflammatory reaction around CMV inclusions was not prominent in
the early stage of pregnancy. Diagnostic confirmation was obtained by in s
itu hybridization (ISH) using a biotinylated CMV-DNA probe, which demonstra
ted intranuclear inclusions and sometimes recognized cells that did not sho
w intranuclear inclusion.