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There is tacit agreement among the Tryptophan synthase international community that no laboratory testing for CMV is needed, unless indicated by particular clinical conditions such as abnormal ultrasonographic findings. Even though it does not offer full protection, acquired immunity will defend the mother from primary infection in pregnancy which carries a much greater risk of fetal damage. Any reinfection or reactivation of infection carries the same risk as pregnancy itself. For these reasons, the information on maternal status before conception precludes the need for screening during pregnancy [33]. Non-immune pregnant women at the early prenatal visit (week 8�C10) are at risk of acquiring primary infection. First and foremost they must be informed of hygiene and behaviour measures (avoiding direct contact with organic materials, close contact with pre-school children and frequent thorough hand-washing) to reduce the chance of infection [13]. Women with daily household or occupational contact with children www.selleckchem.com/products/ch5424802.html Seronegative pregnant women must also undergo periodic serological testing. Although there are no universally accepted guidelines, a second testing should be done at 15�C16?weeks of pregnancy and no later than is reasonable to implement fetal investigations in the case of seroconversion. A positive result allows for the optimal timing of prenatal diagnosis (20�C21?weeks of gestation) considering the time limit for termination of pregnancy in several countries [34]. If the mother continues to be seronegative, serological follow-up testing can be limited or confined to one more test at 35�C37?weeks to select newborns at risk of congenital infection in the case of late seroconversion. Diagnosis of CMV infection is more complex in women who are unaware of their serological status before pregnancy. As most infections are asymptomatic, the only way to disclose primary infection is to implement specific serological testing selleck compound as early in pregnancy as possible (before week?12�C16 of gestation). Recommendations for management of CMV infection during pregnancy are shown in Fig.?1. The fetal compartment can be studied by invasive and non-invasive prenatal diagnostic investigation. Ultrasound has the advantage of not being invasive and will disclose any structural or growth abnormalities caused by CMV infection, but its sensitivity is poor and it correctly identifies no more than 20% of infected babies, even in a selected population [35,36].