Pathology
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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Cytomegalovirus
Introduction

A member of the herpesvirus family. The risk of teratogenic activity is cca 10%. Infection during pregnancy can either be primary or a reactivation of a latent virus. Fortunately the infection is asymptomatic in most cases. Maternal imunity modifies the process of the disease, but it does not prevent transplacental transmission. The risk is greatest during the second trimester. Since organogenesis is practically finished by this time, malformations are rare, but virus caused organ damage is usually serious.

Macroscopic appearance

Inflammatory damage of the CNS which lead to microcephaly, mental retardation and deafness; hepatosplenomegaly is also present.

Histology

Typical nuclear and cytoplasmatic cytomegalic inclusions can be found in the damaged organs as well as in the inflammed placenta and fetal membranes. Nuclear inclusions are more distinct and are surrounded by characteristic round halo. Placental changes get to be more distinct during the later stages of gestation: diffuse villitis with plasma cell infiltration, with foci of necrosis and hemorrhage. CMV inclusions are sometimes present in the stromal cells of villi.