Title INFEKCIJA CITOMEGALOVIRUSOM U TRUDNOĆI
Title (english) CYTOMEGALOVIRUS INFECTION IN PREGNANCY
Author Marina Rumora
Mentor Aleks Finderle (mentor)
Committee member Tea Štimac (predsjednik povjerenstva)
Committee member Vedran Frančišković (član povjerenstva)
Committee member Ivica Pavić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Gynaecology and Obstetrics) Rijeka
Defense date and country 2020-07-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Citomegalovirus (CMV) je DNA virus endemičan u cijelom svijetu. Seroprevalencija u populaciji iznosi 40-90 %, ovisno o sociekonomskom statusu i zemljopisnom položaju. U većini slučajeva, infekcija CMV-om u zdravoj populaciji ostaje nedijagnosticirana zbog nekarakteristične kliničke slike i blagog tijeka bolesti, a ozbiljnija klinička slika prisutna je kod imunokompromitiranih bolesnika. Infekcija CMV-om u trudnoći ne povećava opasnost za zdravlje majke, međutim predstavlja rizik za nepovoljan ishod trudnoće i zdravlje djeteta. Istraživanja su pokazala kako je u razvijenim zemljama 0,6 do 0,7 % novorođenčadi inficirano CMV-om. Iako infekcija ploda tijekom trudnoće najčešće ne izaziva nikakve promjene, u 10 % do 15 % inficirane djece razvit će se simptomatska bolest, obilježena simptomima brojnih organa, posebice retikuloendotelnog i središnjeg živčanog sustava. Naime, kongenitalna infekcija CMV-om je glavni negenetski uzrok senzorineuralnog gubitka sluha, te neurorazvojnih abnormalnosti u novorođenčadi. Primarna infekcija u prvoj polovici trudnoće rezultira težom kliničkom slikom, zbog čega se razmatra uvođenje sustavnog probira trudnica. Dijagnozu CMV infekcije moguće je postići serološkim testiranjem trudnice ili prenatalnom dijagnostikom. Serološko testiranje trudnica je neinvazivan i pouzdan dijagnostički postupak koji se temelji na otkrivanju CMV IgG i IgM protutijela te testu avidnosti IgG protutijela. Prenatalna dijagnoza uključuje ultrazvučnu dijagnostiku, magnetnu rezonancu te invazivne metode poput amniocenteze i kordocenteze. Kako bi se smanjio transplacentarni prijenos virusa i učestalost simptomatske kongenitalne infekcije, istražuju se brojne mogućnosti liječenja trudnica s dokazanom CMV infekcijom. U obzir trenutno dolazi pasivna imunizacija CMV hiperimunim globulinom, aktivna imunizacija i antivirusno liječenje, međutim potrebno je provesti dodatna istraživanja u svrhu pronalaska najučinkovitijeg lijeka.
Abstract (english) Cytomegalovirus (CMV) is a DNA virus endemic worldwide. The seroprevalence in the population is 40-90 %, depending on the socioeconomic status and geographical location. In most cases, CMV infection in a healthy population remains undiagnosed due to the uncharacteristic clinical presentation and mild course of the disease, and a more serious clinical presentation is present in immunocompromised patients. CMV infection in pregnancy does not increase the risk to the health of the mother, however it poses a risk to an adverse pregnancy outcome and the health of the baby. Studies have shown that in developed countries 0.6 to 0.7 % of newborns are infected with CMV. Although infection of the fetus during pregnancy usually does not cause any changes, 10 % to 15 % of infected children will develop symptomatic disease, characterized by symptoms of numerous organs, especially the reticuloendothelial and central nervous systems. Namely, congenital CMV infection is the main non-genetic cause of sensorineural hearing loss and neurodevelopmental abnormalities in the newborn. Primary infection in the first half of pregnancy results in a more severe clinical presentation, which is why the introduction of systematic screening of pregnant women is being considered. The diagnosis of CMV infection can be achieved by serological testing of the pregnant woman or prenatal diagnosis. Serological testing of pregnant women is a non-invasive and reliable diagnostic procedure based on the detection of CMV IgG and IgM antibodies and the avidity test of IgG antibodies. Prenatal diagnosis includes ultrasound, magnetic resonance imaging, and invasive methods such as amniocentesis and cordocentesis. To reduce transplacental virus transmission and the incidence of symptomatic congenital infection, a number of treatment options for pregnant women with proven CMV infection are being explored.
Passive immunization with CMV hyperimmune globulin, active immunization, and antiviral therapy are currently being considered, but further research is needed to find the most effective drug.
Keywords
Citomegalovirus
kongenitalna infekcija
trudnoća
Keywords (english)
congenital infection
Cytomegalovirus
pregnancy
Language croatian
URN:NBN urn:nbn:hr:184:220492
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-11-30 14:45:44