What effects CMV infection will have on my foetus?
Q: I am two months pregnant, for the first time. I was tested for ToRCH panel (IgM and IgG) last month in which few IgGs (such as rubella, CMV and HSV) were positive. However, CMV IgM was equivocal (rubella IgM was negative) since CMV IgM index value was 0.455 (<0.399 negative; 0.40-0.499 equivocal, >0.50 positive). Again we did the same test after 2 weeks to another lab where the result was positive with 2.2EU/ML (cut off ratio is <0.9, 0.9-1, >1). To confirm it again we did a third test after another week in which the result was negative with index value 0.543 (<0.80, 0.80-1.20, >1.20). Since the reference range was changed in first and third test from the same lab, we approached the chief of the lab where I was told that the reference range was changed according to test kit. To make us satisfied, the chief of laboratory allowed me to get another test free of cost the next day where 0.612 index value was found under the same reference range with the last one (<0.80, 0.80-1.20, >1.20). According to their two latest tests, I am negative with CMV IgM. My consulting doctor was also confused about this. My query is does this index reference range keep changing with test kit to kit? Now, can I take myself as a negative CMV person? Even if it is positive, we have decided to go ahead with pregnancy, what may be the effects and risk? What steps should be taken during pregnancy to reduce this infection?
A:If two tests from same lab are negative for CMV IgM, take it as negative. There is no treatment as such for CMV infection during pregnancy. The infection is transmitted through droplets (and so is seen in women working in day care centres, e.g. nursery teachers, nurses in paediatric wards), through blood and also sexually. Prevalence of CMV infection is quite high here (IgG). Good thing is that though infection does not confer immunity (unlike rubella), side effects of reinfection on the fetus are very rare (<1%) and usually minor. I think you should just leave things on God and I am sure you and baby will do well. Just inform the ultrasonologist when you undergo scan for fetal anomalies, and also make sure the neonatologist is informed about these reports after baby is born so they check him/her thoroughly.