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Vol. 33, No. 2, 2013
Issue release date: March 2013
Section title: Novel Insights from Clinical Practice
Fetal Diagn Ther 2013;33:133-136
(DOI:10.1159/000342756)

Midtrimester Fetal Herpes Simplex-2 Diagnosis by Serology, Culture and Quantitative Polymerase Chain Reaction

Curtin W.M. · Menegus M.A. · Patru M.-M. · Peterson C.J. · Metlay L.A. · Mooney R.A. · Stanwood N.L. · Scheible A.L. · Dorgan A.
aDivision of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Pathology, Penn State University Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pa., and bDivision of Maternal-Fetal Medicine, and Departments of cPathology and Laboratory Medicine and dObstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, N.Y., and eDepartment of Obstetrics, Gynecology and Reproductive Science, Yale School of Medicine, New Haven, Conn., USA

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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: 4/25/2012 7:59:26 AM
Accepted: 7/1/2012
Published online: 10/11/2012

Number of Print Pages: 4
Number of Figures: 3
Number of Tables: 0

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

The acquisition of herpes simplex virus (HSV) in utero comprises a minority of neonatal herpes infections. Prenatal diagnosis is rare. We describe a midtrimester diagnosis of fetal HSV-2 infection. Ultrasound at 20 weeks for elevated maternal serum α-fetoprotein (MSAFP) showed lagging fetal growth, echogenic bowel, echogenic myocardium, and liver with a mottled pattern of echogenicity. Amniocentesis demonstrated normal karyotype, elevated AFP and positive acetylcholinesterase. Culture isolated HSV-2 with an aberrant growth pattern. Maternal serology was positive for HSV-2. Quantitative DNA polymerase chain reaction (PCR) showed 59 million copies/ml. Fetal autopsy demonstrated widespread tissue necrosis but only sparse HSV-2 inclusions. Fetal HSV-2 infection can be suspected when an elevated MSAFP accompanies ultrasound findings suggesting perinatal infection. Maternal HSV serology, amniotic fluid culture and quantitative PCR are recommended for diagnostic certainty and counseling.


  

Author Contacts

William M. Curtin, MD
Mail Code H103, 500 University Dr., PO Box 850
Penn State Milton S. Hershey Medical Center
Hershey, PA 17033-0850 (USA)
E-Mail wcurtin@hmc.psu.edu

  

Article Information

Received: April 25, 2012
Accepted after revision: July 1, 2012
Published online: October 11, 2012
Number of Print Pages : 4
Number of Figures : 3, Number of Tables : 0, Number of References : 11

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 33, No. 2, Year 2013 (Cover Date: March 2013)

Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: 4/25/2012 7:59:26 AM
Accepted: 7/1/2012
Published online: 10/11/2012

Number of Print Pages: 4
Number of Figures: 3
Number of Tables: 0

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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