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CMV Virus in pregnancy

  1. MACSUNSHINE

    apricot / 276 posts

    @thepapedbutterfly I would demand the test, not sure why they would ever object to ordering the bloodwork. For me the symptoms were a very rough cold, nothing too severe but a fierce cold. Good luck!

  2. Academicsocialite

    olive / 54 posts

    If your OB won't test for CMV when you specifically request it, I would find another doctor. You could also ask your primary care dr to run the test in the meantime. My primary physician did my bloodwork at my physical and it was no big deal - they run for IgM and IgG antibodies so it's really two tests. The challenge is what happens if the results indicate a recent infection or if you test negative. Most drs aren't experts in immunology or CMV specifically. I'm happy to share what I know. I am 35 weeks pregnant after my TFMR last year, and my CMV levels showed latent infection throughout this pregnancy, so I have done a lot of reading and research into avidity and antibody levels, if it's at all helpful.

  3. Academicsocialite

    olive / 54 posts

    @MACSUNSHINE: I'm so sorry you are dealing with CMV in your pregnancy. But so lucky that you found out about it and could get the valacyclovir (is that what you are getting?) treatments. It was too late for me by the time they discovered the issues with my son's brain development. I also struggled with latent CMV in my current pregnancy and I'm due next month. If you ever want to chat, I'm happy to be in touch. I know how stressful it can be.

  4. MACSUNSHINE

    apricot / 276 posts

    @academicsocialite thank you so much! I will definitely reach out should I need to talk. I have come to terms with it and I am grateful for the extra information and monitoring at this point.

    I don’t know if I am receiving the antibodies or not, it is a blind study. It was the only option offered to me, my doctor and I did not see a downside to participating.

  5. thepaperbutterfly

    grape / 98 posts

    Thanks ladies for the advice My OB hasn't refused to do the test. I never specifically asked him to do it. Not yet at least. It was my PCP who couldn't do it, which is kind of weird I guess because he is associated with a large medical/teaching hospital. He did test me for several other viruses like varicella, and I had antibodies against it.

    Unfortunately I have a complicated medical history, and it is difficult to find a doctor that treats me like a human being. I worked with this OB during my last pregnancy, and I liked him a lot. I did press for some sort of test last pregnancy (I think it had to do with the liver) because I was itching like crazy, and that was a symptom of the disease. He ordered the test and it came back negative.

    @ACADEMICSOCIALITE I was reading up on CMV testing, and saw that there was an IgG test and an IgM test. From what I read IgM would indicate a recent infection and IgG would indicate a previous infection. Though I found this statement from the CDC.

    "Routine screening for primary CMV infection during pregnancy is not recommended in the United States. Most laboratory tests currently available cannot conclusively detect if a primary CMV infection occurred during pregnancy. This makes it difficult to counsel pregnant women about the risk to their fetuses. The lack of a proven treatment to prevent or treat infection of the fetus reduces the potential benefits of prenatal screening."

    Soooooo, I'm worried about a potential false positive. The best time to be tested would have been prior to pregnancy. Also, if I find out that I have an active infection I'm not sure what could even be done. I don't know if the Immunoglobin is a standard treatment.

    If my baby has defects, what is the typical time frame for detection? I read a research paper that was a case study and the abnormalities were detected at 17 weeks.

    Did you have any symptoms of the CMV infection? I haven't been sick at all except for that one day I went into the ER, but my symptoms lasted less than 24 hours so it felt like it was so infection I had before or else why would it be so short, or maybe it was hormones instead of an infection.

    The other thing is that I taught ballet to children 3-5 years old along with older kids and adults for like 8 years, and I wasn't super hygienic XD So I probably contracted it at some point, but without a blood test I can't be sure.

    Thanks so much for your help

  6. mrsbubbletea

    nectarine / 2821 posts

    @Academicsocialite: so happy to hear you are expecting again!

  7. Academicsocialite

    olive / 54 posts

    @thepaperbutterfly: So, based on my layperson's understanding, testing for CMV works like this:

    Presence of IgG - indicates CMV infection at some point in your life.
    Presence of IgG and IgM - indicates current infection
    Presence of IgM only - indicates very recent infection.

    If IgM is detected at any level, the next step is to run an avidity test to try to determine how recent the infection is and whether it is a result of first-time exposure to the virus. If the avidity is >60, this indicates an infection more than 6 months in the past and also, usually, means your body has the antibodies to fight the infection and protect a growing baby. So with testing, there can be a process of elimination to find out how at risk you might be.

    If you have a recent primary infection, early in pregnancy, the rate of transmission/fetal infection/severe outcomes is thought to be as high as 20-25%, but that's still an 75-80% chance the baby will be completely healthy. The chances of what happened in our pregnancy were so low, we had to hit every "worst" scenario to end up with a baby so severely affected, which we did. I didn't ever notice any symptoms of the virus, but did have a rough first trimester with fatigue (CMV can sometimes present like mono). Issues with the baby's brain development were not detected until a 26-week growth scan. CMV infection transmission can be detected with amniocentesis, but not reliably until after 21 weeks. Often the first sign of an issue is a "bright" or echogenic bowel on ultrasound. But we never had that red flag in our case. Everything for us was fine, until it wasn't.

    All that said, my advice it try not to worry but push for the testing and don't listen to anyone who says it's not necessary. The reality is that most doctors haven't seen many CMV cases in their practices, so they are just not well-informed on how to make determinations about testing and care. Just my 2 cents.

  8. Academicsocialite

    olive / 54 posts

    @mrsbubbletea: thank you so much. It has been a tough journey, but I am finally starting to relax and believe that I'll get to bring home a baby this time.

  9. MACSUNSHINE

    apricot / 276 posts

    @Academicsocialite: I apologize, I had not read back through the entire thread. I am sorry you had to experience that, I appreciate your honesty and perspective.

    So happy for you and wish you the best!

  10. Mrsbells

    squash / 13199 posts

    This thread has really scared me a bit. One more thing to worry about

  11. Ms.Mermaid

    kiwi / 745 posts

    @Mrsbells: my cousin’s daughter has CMV and severe birth defects/developmental delays and I’ve been terrified of it my whole pregnancy. I stopped sharing food/drinks with my daughter when we started TTC and told my husband to do the same, he didn’t actually stop until first trimester. I washed my hands constantly first trimester and admit that I’ve become marginally more lax second trimester. I was never a lip kisser though my daughter tries to kiss me on the lips sometimes. But also if you have a young child and are pregnant, you are so immunocompromised that it’s not a good idea to share drinks anyway.

  12. thepaperbutterfly

    grape / 98 posts

    @AcademicSocialite: Thank you so much for taking the time to answer my questions! I just asked the doctor to test for it, so hopefully that will give me some more definitive answers.

  13. MACSUNSHINE

    apricot / 276 posts

    @mrsbells please don’t be too stressed, honestly there are any number of things to be concerned about during pregnancy. This is one that if you are aware of the risks you can minimize and you can be tested to see if you have been infected before. My understanding is that the risk is with a first time infection in early pregnancy. I did not know the risks and shared everything with my DS, the full effect is not yet known but we do not anticipate severe birth defects as the infection was very late in my first trimester.

    I would talk to your doctor and test as you deem appropriate. We have friends that went through IVF with loads of genetic testing and their baby was born with a number of birth defects that were never identified until birth. They still do not know the full scope of what they are dealing with developmentally. This has helped me keep things in perspective, pregnancy and parenthood are full of worries and unknowns.

    CMV is something I wish I had known about as it is something that if educated on you can mitigate the risk.

  14. teawithpaloma

    apricot / 490 posts

    Hugs to all on this thread. I still cannot believe we are not taught more about basic prevention.

  15. Academicsocialite

    olive / 54 posts

    @Mrsbells: Just to say, I totally echo @macsunshine on this. There's absolutely no cause to panic about this, but I do believe having more info is better than being in the dark. As a pregnant woman, the thing I recommend first is to know your CMV status. If you have the antibodies from a past infection, that significantly reduces your risk. And then, if you test negative, you'll know to take more precautions. My dear friend had her titers checked after our loss and she found out she was negative for CMV antibodies, so she was really careful throughout her pregnancy, and they checked her levels once a trimester to make sure she never caught it. So it's not unreasonable to press your care provider to give you this info.

  16. teawithpaloma

    apricot / 490 posts

    @Academicsocialite: I totally agree. @Mrsbells: I just asked my provider. I said this is causing me undue anxiety and I want it checked. If he didn't do it I would have found someone else.

  17. teawithpaloma

    apricot / 490 posts

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