Midtrimester fetal herpes simplex-2 diagnosis by serology, culture and quantitative polymerase chain reaction

William Curtin, Marilyn A. Menegus, Maria Magdalena Patru, C. Jeanne Peterson, Leon A. Metlay, Robert A. Mooney, Nancy L. Stanwood, Amy L. Scheible, Angela Dorgan

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9 Scopus citations

Abstract

The acquisition of herpes simplex virus (HSV) in utero comprises a minority of neonatal herpes infections. Prenatal diagnosis is rare. We describe a midtrimester diagnosis of fetal HSV-2 infection. Ultrasound at 20 weeks for elevated maternal serum α-fetoprotein (MSAFP) showed lagging fetal growth, echogenic bowel, echogenic myocardium, and liver with a mottled pattern of echogenicity. Amniocentesis demonstrated normal karyotype, elevated AFP and positive acetylcholinesterase. Culture isolated HSV-2 with an aberrant growth pattern. Maternal serology was positive for HSV-2. Quantitative DNA polymerase chain reaction (PCR) showed 59 million copies/ml. Fetal autopsy demonstrated widespread tissue necrosis but only sparse HSV-2 inclusions. Fetal HSV-2 infection can be suspected when an elevated MSAFP accompanies ultrasound findings suggesting perinatal infection. Maternal HSV serology, amniotic fluid culture and quantitative PCR are recommended for diagnostic certainty and counseling.

Original languageEnglish (US)
Pages (from-to)133-136
Number of pages4
JournalFetal Diagnosis and Therapy
Volume33
Issue number2
DOIs
Publication statusPublished - Mar 1 2013

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All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

Curtin, W., Menegus, M. A., Patru, M. M., Jeanne Peterson, C., Metlay, L. A., Mooney, R. A., ... Dorgan, A. (2013). Midtrimester fetal herpes simplex-2 diagnosis by serology, culture and quantitative polymerase chain reaction. Fetal Diagnosis and Therapy, 33(2), 133-136. https://doi.org/10.1159/000342756