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Home / Scared of Having a Baby With Birth Defects

Scared of Having a Baby With Birth Defects

Cytomegalovirus, or CMV, is a very common member of the canker family of viruses. Past age 40, one-half of the adult population has been infected with CMV. Ordinarily, a CMV infection is curt-lived, does not produce noticeable symptoms, and afterward lies dormant in the trunk for life. But what happens if a pregnant woman picks upward CMV for the starting time fourth dimension during pregnancy, or has a recurrent infection from a previous exposure? Are there risks to the fetus? And if so, how can your healthcare provider help to minimize these risks?
In this commodity, we will address the birth defects associated with congenital CMV and ways to protect yourself and your growing baby. If you'd like to know more than about CMV during pregnancy in general, check out our commodityCytomegalovirus (CMV) Infection.

Built CMV Birth Defects:  In The Womb

Not all babies born to CMV-infected mothers develop congenital CMV, and not all that do pick up CMV will experience long-term effects. Yet, it is important to be aware of the risks because some of them can bear on how your kid will live his or her life.

What is the risk of passing CMV to my baby during pregnancy?

In general, one of every 150 to 200 babies in the USA is built-in with congenital CMV. This makes CMV the nearly frequent built viral infection. Though this seems like a large per centum of births, but ane in 5 of these infants born with congenital CMV will feel any adverse symptoms or long-term issues.
The virus has the potential to travel through the female parent's blood and pass through the placenta, infecting the developing babe.

If yous have the virus before you become pregnant:  There is a very depression adventure of passing it to your baby. The chance heightens if you are reinfected with a different strain of the virus (see statistic below), or if you have a reactivation of the virus during your pregnancy.

If you contract the virus (primary infection) during your pregnancy:  It is more likely to pass on CMV to your baby if you get a primary infection during the pregnancy than it is to pass information technology if you were previously infected. If you accept a primary CMV infection during pregnancy, in that location is approximately a 40% run a risk of passing the virus to your baby.
The risk of transmission from mother to babe is highest if she gets a principal CMV infection in the 3rd trimester (forty-seventy%) and is everyman if the primary infection begins in the start or second trimesters (30-40%).

Can congenital CMV harm my developing baby?

CMV can pass to your babe at any fourth dimension during your pregnancy, and any built CMV symptoms that are nowadays later on nascency develop in the womb. Then in a sense, yes, CMV tin can harm your developing infant.
However, the chance of death to a fetus from contracting CMV is extremely pocket-sized. Doctors accept witness seizures in a fetus after contracting congenital CMV, but nigh of these babies are able to survive and thrive well past birth.
There are quite a few abnormal ultrasound readings that may indicate a congenital CMV infection, including but not limited to:

  • Organomegaly (abnormal organ enlargement) – spleen, liver, and others
  • Abnormal dilation of lateral brain ventricles, the ureter, and/or the renal pelvis
  • Intracranial calcifications
  • Microcephaly
  • Placental thickening
  • Fetal hydrops
  • Ascites
  • Hepatic, intestinal, or periventricular echodensities

1 or more of these may point congenital CMV; notwithstanding, many of these abnormalities are linked to a plethora of other diseases or syndromes.

If there are concerns, are in that location tests to bank check my babe's CMV condition in utero?

Yes, at that place is 1 test that tin test your growing babe'southward congenital CMV status while notwithstanding in the womb. This process is called amniocentesis, which involves the ultrasound-guided insertion of a needle into the amniotic sac to collect a sample of amniotic fluid for testing. Amniocentesis serves to diagnose a listing of genetic abnormalities or diseases.
This testing is ordinarily performed most delivery (stop of 3rd trimester) or in the 14-20 calendar week range. Though amniocentesis can give parents and doctors a better idea of any issues or defects the baby may face, there are some risks to the procedure:

  • Miscarriage (ane/200 – 1/400 pregnancies using amniocentesis)
  • Infection
  • Amniotic fluid leakage or full break of the sac
  • Accidental poke of the fetus with needle
  • Potential to mix the mother's claret with fetus's

If there were whatsoever abnormalities on an ultrasound, have a talk with your doctor virtually your options and the chance to yous and your baby with amniocentesis. Many times, the benefits of knowing the results outweigh the risks. This is a personal conclusion, and not one your doc can make for you, though he/she may suggest a certain route.
Possibly the greatest do good of determining the infant's built CMV status is the potential for rapid treatment post-obit nascence. If there are any symptoms of congenital CMV present, the babe may exist able to receive faster treatment with antivirals than if testing were performed after nativity just.

Are at that place any treatments if my baby is diagnosed with congenital CMV in the womb?

Although not many, there are a couple of routes you and your doctor(south) can explore afterward finding out that your developing infant has built CMV following amniocentesis.
I option is to inquire about using CMV-IGIV. This involves an intravenous (4) influx of anti-CMV immunoglobulins (IG) or antibodies to assistance the baby and mother fight a primary CMV infection. This treatment has not (of withal) been proven highly effective, and is not available everywhere.
Another option is to explore whatever current clinical trials. To research what may exist bachelor to you, speak with your physician, contact the National CMV Foundation here, or visit the National Institutes of Wellness'southward (NIH) clinical trial search.
It is of import to retrieve that non all options are available to everyone, and may depend on your medico or hospital, accessibility of a proposed treatment, your medical groundwork, the stage of a specific clinical trial, and/or your power to travel.
Sometimes, the best treatment program will exist to look until after birth to start the infant on antiviral therapies.

Congenital CMV Nativity Defects: Types

Which nativity defects are associated with congenital CMV?

The main ways that congenital CMV tin affect an infant immediately or overt time are:

  1. Hearing loss
  2. Mental inability
  3. Seizures
  4. Vision loss
  5. Decreased muscle force (including cognitive palsy)
  6. Decreased coordination
  7. Microcephaly

However, it is important to recollect that the majority of infants born with CMV do not suffer any long-term effects or ailments.

What should I expect subsequently nativity?

If you and your doctors are aware that yous've had a reactivation of the virus or primary infection of CMV during your pregnancy, they volition take either saliva, urine, or claret sample from your baby in the first two-iii weeks of life to see if your baby has built CMV. These tests bank check for the live virus or viral Dna rather than for antibodies since the quondam two are more accurate. They volition as well look for signs of CMV in your newborn.
Of those infants who exam positive for congenital CMV, almost 10% of them will take symptoms associated with congenital CMV that are apparent at nascency:

  • microcephaly
  • pre-term birth
  • low birth-weight
  • seizures
  • problems with or an enlarged liver or spleen
  • hearing loss

Of that ten% who show signs at birth, 40-60% will have long-term difficulties, such as:

  • hearing loss
  • mental inability
  • vision loss
  • seizures
  • coordination loss
  • decreased musculus tone or ability (including cerebral palsy)
  • calcifications in the brain
  • feeding or sleeping bug
  • expiry (very rare)

Hearing loss appears to be the merely difficulty that may develop subsequently on in infants who have congenital CMV but do non present with symptoms at birth. This accounts for approximately 10-twenty% of infants with CMV who donon present symptoms at birth.
And so, in review:

x% of babies with congenital CMV that are symptomatic at birth volition have long-term difficulties of some class.
ten-20% of babies with congenital CMV that are NOT symptomatic at birth will have some degree of long-term hearing loss.

Congenital CMV treatment

Built CMV Nascency Defects:  Treatments & Beyond

Are there whatsoever treatments for babies born with symptomatic congenital CMV?

Other than treating the symptoms, the only current treatment bachelor is antiviral medication. Ganciclovir and Valganciclovir are the two options for antivirals, but both take potentially severe side effects. Even so, if your pediatrician approves, it may be a good and necessary step for your family.

These two antivirals may gainsay initial symptoms from becoming more severe long-term effects. That does not hateful that any and all symptoms volition cease, but it could mean a decrease in severity, particularly in cases with hearing loss and developmental concerns.

What could a diagnosis of built CMV hateful for my child, fifty-fifty if they don't have symptoms at birth?

Babies that receive a diagnosis of congenital CMV after birth notwithstanding have no symptoms may have no long-term difficulties at all. However, since some are known to develop over time, the CDC suggests that these children have regularly scheduled hearing and vision checks throughout childhood and adolescence.
Since developmental (mental) delays can also occur months or years after an asymptomatic appearance at birth, your child should be monitored for whatsoever signs of developmental difficulty as he/she grows up.

Are there resource to help me as a parent of a child/infant living with a permanent disability from CMV?

Yes, there are! There are quite a few organizations that are specific to congenital CMV and helping parents and their affected children through the symptoms and life changes.
Offset of all, in that location are organizations specific to some of the mutual birth defects of CMV that tin assistance support you on your unique journey:

  • Cerebral Palsy:  CerebralPalsy.org, Cerebral Palsy Guidance, United Cerebral Palsy
  • Hearing Loss:  Easily & Voices, NCHAM, Alexander Graham Bell Clan, National Centre on Deafened-Blindness
  • Vision Loss:  National Federation of the Blind, National Center on Deaf-Blindness
  • Epilepsy:  Epilepsy Foundation

There are also some organizations specific to congenital CMV support equally well:

  • The Built CMV Illness Inquiry Clinic & Directory at Baylor in Houston, TX (connection to a parent support network)
  • CMV Blog, Educational downloads, and Parent Stories from the National CMV Foundation
  • (United kingdom) Social Media Support Groups, Resources, Get a Fellow member (with a support squad) at CMV Action
  • (AU) Family Support Forum & other Resources at CMV Australia
  • Cheque out Facebook groups and personal blogs for more personal stories of families afflicted by congenital CMV

Prevention of CMV Earlier & During Pregnancy

It's hard to believe that with and then many problems with built CMV in the world today, that information technology is actually a preventable disease. Before and during pregnancy, you can take basic hygiene steps to avoid condign infected. Prior to pregnancy, you tin observe out your CMV status.

Before Y'all Get Pregnant:

As you and your partner are planning to conceive, information technology is a good idea to brand yourself aware of your own CMV status. To do this, y'all tin asking a CMV antibiotic test for IgG and IgM (two types of antibodies) from your doctor.
If yous test positive for a main infection (IgG & IgM +), it is suggested to wait until your IgM returns to a low enough level to signify a not-principal infection before trying to conceive (TTC).
If you are either not infected (IgG & IgM -) or take indications of a non-primary/past infection (IgG + and IgM -), and then there is usually not a reason to wait to TTC. In the case of no previous infection, the largest business organisation during pregnancy is a new CMV infection (run across "Later on" for tips on prevention).

Afterward You Get Significant:

There is no way to guarantee that you will not pick upwardly CMV or experience a reactivation. Notwithstanding, hither are some things that you tin can exercise or avoid to reduce your chances of a primary CMV infection.
DO:

  • Wash your hands with lather and warm water often, specially:
    • Subsequently playing with children
    • After coming into contact with anyone'southward, peculiarly children's, saliva or tears
    • Before touching your face up (optics, mouth, nose – where a virus could enter)
    • Afterward using the restroom
    • Later on changing a diaper, using a tissue, etc.
  • Eat healthily and exercise during your pregnancy (keeps the immune system stiff)
  • Apply a condom each time you lot are sexually active to avoid exchanging fluids
  • Clean children'due south toys and counters/handles that children often bear on

Do NOT:

  • Have sexual contact, including kissing and any type of sexual practice (especially unprotected), with new partners
  • Share drinks or utensils with others
  • Kiss children on the oral cavity (brow & cheeks are safer to avoid saliva)

Basically, practicing general hygiene, avoiding new sexual partners, and limiting contact with children's saliva, tears, etc. can help you avoid CMV.
Women who work in daycares or with children tend to have a higher incidence of contracting CMV. If this applies to you, talk to your doctor about your risk, wash your hands oftentimes, and don't impact your face at work.

CMV and Breastfeeding

You've probably heard how beneficial breastfeeding is. But, what about when there'southward a business near the mom having some sort of sickness, like CMV? Equally always, we suggest speaking with your doctor if you know you've had a principal CMV infection during your pregnancy and wish to breastfeed.

If your baby is tested and confirmed for congenital CMV, and then there should not be any issues with breastfeeding since both yous and the infant already accept the virus.

If y'all know you (ane) have/had a primary infection during your pregnancy, (two) may have had a reactivation of the virus, or (iii) are high-risk for contracting CMV (ex. work in a daycare), then y'all will desire to take your baby's test results and, if negative, speak with your dr. earlier breastfeeding. You may also be able to have your breast milk tested for the live virus.

If your infant does have congenital CMV, then it should be safe for y'all to breastfeed since transmission has already occurred. A conversation with your doctor will help you counterbalance the benefits and risks if your baby does not take congenital CMV.

What if my baby gets CMV from me in my breast milk?

Typically, if a infant gets CMV from a female parent'due south chest milk after birth, there are natural anti-CMV antibodies in the baby's system. These are passed from the mother to the baby in utero (third trimester) or in the breast milk itself. Most infants (and humans of whatsoever age) who become CMV do not have any symptoms at all and may exist minor if at that place are any.

When CMV is transferred to an babe through chest milk and/or other fluids later nativity, information technology is termed perinatal CMV.
The greatest concern comes when the infant is preterm and is not born with built CMV. Pre-term infants are not expected to accept received the full dose of maternal antibodies during the tertiary trimester and are thus less protected against CMV in the breastmilk. The infant may develop more than serious (simply treatable & temporary) symptoms, such as:

  • enlarged or infected spleen or liver
  • sepsis-like syndrome (tin lead to apnea, irksome heart rate, or distended abdomen)
  • depression platelet count
  • low white blood cell count
  • high liver enzyme corporeality

Though much of this sounds serious, most infants are able to spontaneously recover. Some may be treated with an antiviral, such as ganciclovir or valganciclovir, to aid rid the infection. These medications take the potential for serious side effects, but your doctor will assist you make up one's mind if the benefits outweigh the risks.

Compiled using information from the following sources:

i. National CMV Foundation.

https://www.nationalcmv.org/home.aspx

ii. System of Teratology Data Specialists (OTIS, 2017): Cytomegalovirus (CMV) Fact Sail. Available through Mother To Baby.

https://mothertobaby.org/fact-sheets/cytomegalovirus-cmv-pregnancy/pdf/

3. Centers for Disease Control & Prevention: Cytomegalovirus (CMV) and Congenital CMV Infection.

https://world wide web.cdc.gov/cmv/overview.html

https://world wide web.cdc.gov/cmv/clinical/congenital-cmv.html

4. Medela Breastfeeding United states: Instruction Research on CMV.

https://www.medelabreastfeedingus.com/assets/file/CMV%20Transmission%20and%20Breastmilk%201547692B.pdf

5. CMV Action

https://cmvaction.org.britain/

desailllymindighisent.blogspot.com

Source: https://americanpregnancy.org/healthy-pregnancy/birth-defects/congenital-cmv-birth-defects/