Grand Rounds

A mother with bad obstetric history - Is it due to cytomegalovirus?

Suhani Jain1, Ira Shah2
1Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai, India, 2Consultant in Pediatric Infectious Diseases, Levioza Health Care, Mumbai, India

Address for Correspondence: Suhani Jain, Flat number 402, Ramdeo Arise, Behind Hotel Airport Centre Pt, Wardha Road, Nagpur-440025. Email:

Keywords: Bad obstetric history, Cytomegalovirus, TORCH infections

Clinical Problem:
A 32-year-old pregnant female at 9.5 weeks of gestation presented for ruling out fetal deaths due to intrauterine infection. She has a bad obstetric history with a medical termination of pregnancy (MTP) a year ago at 5.5 months of gestation due to congenital malformations in the baby. She also had a spontaneous abortion at 14 weeks of gestation 6 months ago. While screening for infections in the first pregnancy , it was found that Rubella IgG was positive (73.4 AU/ml), varicella zoster virus (VZV) IgG was positive (1.01 AU/ml) as well as cytomegalovirus (CMV) IgG was raised. For the second pregnancy , Rubella IgG was 117 AU/ml , VZV wasn’t detectable and CMV IgG was 49 AU/ml. For present pregnancy, she was followed up with IgG levels of rubella , VZV and CMV (Table 1).

Table 1. Serial TORCH titres in current pregnancy.
Gestational age (months) Rubella IgG (AU/ml) Varicella zoster IgG (AU/ml) Cytomegalovirus (CMV) IgG (AU/ml) CMV avidity
7 weeks 67 negative 218  
11 weeks     190.45 0.91 (high)

Is the lady’s bad obstetric history due to CMV infection?

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