Grand Rounds

Interpretation of Cytomegalovirus (CMV) serology

Meenakshi Dey1, Suhani Jain2, Ira Shah3
1Pediatric TB Clinic, Department of Pediatric Infectious Diseases, Bai Jerbai Wadia Hospital For Children, Mumbai, India, 2Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai, India, 3Consultant in Pediatric Infectious Diseases, Levioza Health Care, Mumbai, Mumbai

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

Keywords: CMV IgG, CMV avidity, amniocentesis, valacyclovir

Clinical Problem:
A 31 year old primigravida at 12 weeks of gestation was referred to us for evaluation based on the results of a TORCH panel. The test indicated that her cytomegalovirus (CMV) IgG level was 280 Au/ml and Rubella IgG was 48 Au/ml. However, all other TORCH IgG and IgM results were negative. She did not report any significant prior pregnancy-related issues and had no present complaints. She was advised a repeat CMV IgG and Rubella IgG serology after 4 weeks along with avidity test. At 19 weeks of pregnancy, there was an increase in the CMV IgG level to 1240 Au/ml with 98% avidity. The rubella IgG level decreased to 28 Au/ml. Anomaly scan of the baby was normal.

How to interpret the CMV IgG rise? Should amniocentesis be done? What should be the line of management for this patient?

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