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Ultrasound markers of fetal infection part 1: viral infections
Luiz Antonio Bailão1, Newton G Osborne, Maria Christina S Rizzi
1Department of Obstetrics and Gynecology, School of Medicine, University of São Paulo, Brazil.
Abstract:
Diagnosis of fetal infection has depended on identification of pathogens by means of microbiological cultures, immunologic techniques, and special molecular biology techniques that can identify organisms known or suspected of being associated with adverse outcomes of pregnancy. Rubella, cytomegalovirus (CMV), herpes simplex virus (HSV), and human immunodeficiency virus (HIV), for example, are capable of gaining access to the amniotic cavity and producing fetal infection, even when amniotic membranes are intact. Intrauterine invasion by viruses can be associated with maternal symptoms of infection or can be completely silent. In many instances extensive fetal compromise with irreversible structural damage or fetal death will have occurred by the time infection is confirmed by culture or other histopathological methods. The evidence of fetal infection may be as subtle as nascent intrauterine growth restriction (IUGR), mildly inappropriate calcification of fetal organs, placenta, cord, and membranes, and failure to adequately develop fetal fat reserves. The evidence of infection may be as dramatic as obvious fetal malformation, severe central nervous system structural damage, or fetal death. Sonography is capable of detecting most of the grave alterations and some of the subtle effects that are typical of fetal infection.
Insights
Diagnosing fetal infections relies on identifying pathogens, but sonography can detect subtle and severe effects of intrauterine infections, aiding early intervention. This imaging technique helps identify fetal compromise and structural damage associated with prenatal infections.
Area of Science:
- Prenatal diagnostics
- Fetal medicine
- Infectious disease in pregnancy
Background:
- Traditional diagnosis of fetal infections relies on pathogen identification via cultures and molecular techniques.
- Viruses like rubella, CMV, HSV, and HIV can infect the fetus, even with intact membranes, causing silent or symptomatic maternal infections.
- Fetal compromise or death may occur before infection confirmation, with subtle signs like intrauterine growth restriction (IUGR) or dramatic malformations.
Purpose of the Study:
- To highlight the role of sonography in diagnosing fetal infections.
- To emphasize the range of sonographic findings associated with fetal infections, from subtle to severe.
- To underscore the importance of early detection for managing adverse pregnancy outcomes.
Main Methods:
- Review of diagnostic techniques for fetal infections.
- Analysis of sonographic findings in cases of intrauterine infection.
- Correlation of sonographic evidence with traditional diagnostic methods.
Main Results:
- Sonography can detect subtle signs of fetal infection, including IUGR and inadequate fat reserves.
- Severe fetal alterations such as malformations and central nervous system damage are identifiable via sonography.
- Sonography aids in identifying the consequences of fetal infections when traditional methods are delayed.
Conclusions:
- Sonography is a valuable tool for detecting the effects of fetal infections.
- Early sonographic detection of fetal infection sequelae can inform management strategies.
- Integrating sonography with traditional methods improves the diagnosis and management of intrauterine infections.
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