Ricerc@Sapienza

Cytomegalovirus (CMV) is the most common congenital viral infection, with birth prevalence ranging from 0.5 to 2%. Congenital CMV (cCMV) is the main nongenetic cause of congenital sensorineural hearing loss and neurological damage. The rate of vertical transmission in primary infection ranges from 30% to 65% if the maternal CMV-seroconversion occurs during the third trimester of pregnancy, and the risk of long-term sequelae is up to 58% in infected children.
cCMV can be suspected in case of mother presenting symptoms, or in case of abnormal ultrasound (US) findings. The detection of CMV DNA in the amniotic fluid is considered the gold standard for the diagnosis of fetal infection, combined with ultrasound assessment, which is useful to evaluate the fetal involvement by detecting cerebral and extracerebral findings suggestive of congenital CMV.
A normal ultrasound examination is reassuring but does not completely exclude the possibility of an infected fetus, symptomatic neonate, or development of long-term neurologic morbidity. Magnetic resonance imaging (MRI) may provide additional information about anomalies, particularly neurologic abnormalities, in infected fetuses with normal ultrasound. The primary aim of this study is to evaluate the role of fetal MRI in detecting anomalies in fetuses with CMV infection and normal US examination; the secondary aim is to determine the optimal gestational age for performing MRI in fetuses affected by such infections. Parental counselling should be improved with a better knowledge of the real predictive value of MRI and US imaging findings in studying the fetal outcome.