Detection of Viral Deoxyribonucleic Acid in Amniotic Fluid: Association with Fetal Malformation and Pregnancy AbnormalitiesReddy U.M. · Baschat A.A. · Zlatnik M.G. · Towbin J.A. · Harman C.R. · Weiner C.P.
aDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Md., bDepartment of Obstetrics and Gynecology, University of California, San Francisco, Calif., and cDepartment of Molecular and Human Genetics, Baylor College of Medicine, Houston, Tex., USA
Objective: To first test the hypothesis that the presence of viral nucleic acid in amniotic fluid (AF) is associated with an abnormal pregnancy outcome, and second, to determine if the overall rate of polymerase chain reaction (PCR) positivity and the distribution of virus types vary geographically. Study Design: Cytomegalovirus (CMV), parvovirus B19, adenovirus, enterovirus, herpes simplex virus, Epstein-Barr virus, and respiratory syncytial virus nucleic acids were sought in 423 AF samples obtained for clinical indications: 284 from the East Coast (EC) and 139 from the Midwest (MW). Results: Gestational age at sampling was 19.1 weeks for EC and 20.1 weeks for MW. 13.5% of karyotypically normal singleton pregnancies (57/423) had a positive AF PCR. 11% of AF PCR from the EC while 18% of AF PCR from the MW were positive (p = 0.06). The most commonly detected viruses were adenovirus (77%), enterovirus (12%), and CMV and parvovirus B19 (5% each). Twenty-four percent of sonographically abnormal pregnancies (33/136) had a positive AF PCR compared to only 8.4% (24/287) of normal pregnancies (p < 0.001). Conclusion: A positive AF PCR is associated with an increased rate of fetal structural malformations, intrauterine growth restriction, hydrops and other fetal abnormalities. There were no significant geographic differences in the incidence of AF viral PCR positivity.
Carl P. Weiner, MD
Department of Obstetrics, Gynecology and Reproductive Sciences
655 West Baltimore Street, 11-033 BRB, Baltimore, MD 21201-1703 (USA)
Tel. +1 410 706 1317 (office), +1 410 825 7765 (home), Fax +1 410 706 5747
Presented at the 22nd Annual Meeting of the Society for Maternal-Fetal Medicine, New Orleans, La., USA, January 14–19, 2002.
Received: February 28, 2003
Accepted after revision: April 7, 2004
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 26
Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)
Vol. 20, No. 3, Year 2005 (Cover Date: May-June 2005)
Journal Editor: W. Holzgreve, Basel; M.I. Evans, New York, N.Y.; H. Nakano, Fukuoka; S. Uzan, Paris; M. Michejda, Washington, D.C.; K.C. Pringle, Wellington; D. Surbek, Basel
ISSN: 1015–3837 (print), 1421–9964 (Online)
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