التفاصيل البيبلوغرافية
| العنوان: |
Maternal high-dose valacyclovir and its correlation with newborn blood viral load and outcome in congenital cytomegalovirus infection. |
| المؤلفون: |
Goncé, Anna, Hawkins-Villarreal, Ameth, Salazar, Laura, Guirado, Laura, Marcos, Maria-Angeles, Pascual Mancho, Jara, Prats, Pilar, López, Marta, Eixarch, Elisenda, Salvia, Maria-Dolors, Fortuny, Claudia, Figueras, Francesc |
| المصدر: |
Journal of Maternal-Fetal & Neonatal Medicine; Oct2022, Vol. 35 Issue 20, p4004-4008, 5p |
| مستخلص: |
Currently, there is no validated treatment for fetal cytomegalovirus (CMV). Two studies suggest that high-dose maternal valacyclovir decreases fetal viral load and improves outcomes in moderately-symptomatic fetuses. We offered valacyclovir in cases of fetal infection lacking ultrasound abnormalities or with non-severe infection. Maternal tolerability, fetal outcome and newborn blood viral load were evaluated in pregnancies of mothers receiving valacyclovir. We performed a case series including 8 pregnancies with fetal CMV classified as unaffected/mildly-moderately affected. Mothers received valacyclovir (8 g/24h) from fetal infection diagnosis to delivery. Standard newborn evaluation was performed, and viremia was determined in the first 48 h of life and compared according to length of maternal treatment and presence/absence of prenatal anomalies. Valacyclovir was administered at a median gestational age of 26.5 weeks (23.8–33.1) in 3 cases without fetal abnormalities, and 5 with mild/moderate abnormalities. Three were 3 first trimester primary infections, one non-primary infection, and in 4 the type of infection was unknown. Valacyclovir was well-tolerated. Fetal features did not progress. Three newborns were asymptomatic, and one was severely affected (bilateral chorioretinitis). The median newborn viral load (IQR) was 502 IU/mL (231–191781) with lower levels when maternal treatment was administered ≥10 weeks, and in cases without fetal abnormalities [median 234 IU/mL (228–711) vs. 4061 (292–510500) p =.18; and 234 IU/mL (228–379500) vs. 711 IU/mL (292–4061) p =.65, respectively], these differences being non-significant. Fetal CMV lesions remained stable with high-dose maternal valacyclovir. Newborn viral load was unchanged despite treatment duration and fetal/neonatal abnormalities. Fetal cytomegalovirus lesions remained stable with high-dose maternal valacyclovir. Newborn viral load was unchanged despite treatment duration and fetal/newborn abnormalities. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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