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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.


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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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

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    External Resources

  7. Diguet A, Patrier S, Eurin D, Chouchene S, Marpeau L, Laquerrière A, et al: Prenatal diagnosis of an exceptional intrauterine herpes simplex infection. Prenat Diagn 2006;26:154-155.
  8. Kimberlin DW: Herpes simplex virus infections of the newborn. Semin Perinatol 2007;31:19-25.
  9. Alanen A, Hukkanen V: Herpes simplex virus DNA in amniotic fluid without neonatal infection. Clin Infect Dis 2000;30:363-367.
  10. Tang JW, Lin M, Chiu L, Koay ES: Viral loads of herpes simplex virus in clinical samples - a 5-year retrospective analysis. J Med Virol 2010;82:1911-1916.
  11. Ville Y: CMV review. Fetal Diagn Ther 2012, in press.