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Master Thesis

Description de l’imagerie anté-natale dans une cohorte multicentrique de 257 cas d’infection materno-foetale à cytomégalovirus

Abstract : Objectives: The seroprevalence of cytomegalovirus is around 50 to 60 % in pregnant women in France. The study’s intent was to assess, from antenatal imagery, sensitivity and predictive value of metal ultrasound and compare them with the symptomatology at the age of at least one year old of the children infected by the CMV. Study design: We conducted a retrospective observational study on 13 hospitals in France. Inclusion criteria were the presence of congenital CMV infection diagnosed during the pregnancy or diagnosed at birth, during the first ten days. The primary outcome was the presence or absence of US call signs of the 2nd or the 3rd trimester. The secondary outcome was the presence or absence of sequelae at the last pediatric visit (at least one year). We then compared the antenatal imagery with the symptomatology at the one year old at least and we we studied the association between congenital CMV infection and the primary outcome using sensitivity, specificity, PPV and NPV. Results: Among 222 patients, 39 presented sequelae at a least one year old, including 18 with severe sequelae. The sensitivity and NPV of US to identify fetuses that will develop at least one sequela were 56 % and 87 %, respectively and increased to 78 and 97 % respectively to identify those with moderate to severe sequelae. Sensitivity and NPV were good in the group of cases diagnosed prenatally: 90% and 96% to identify all sequelae and 100% to identify moderate to severe sequelae. On the other hand, the sensitivity and the NPV were lower in the group of children diagnosed at birth. However, despite the presence of an US sign in 45 % of fetuses with all types of sequelae and 71 % of fetuses with severe to moderate sequelae, the diagnosis of CMV fetopathy was not discussed. the diagnosis was made only at birth. Conclusion: We have shown that the current US screening policy is not sufficient to screen for congenital CMV infection.
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Sally Ren. Description de l’imagerie anté-natale dans une cohorte multicentrique de 257 cas d’infection materno-foetale à cytomégalovirus. Gynécologie et obstétrique. 2019. ⟨dumas-03259302⟩

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