الفهرس 
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Abstract
Human Cytomegalovirus (HCMV) infection still represents the most common and potentially serious viral complication in pregnant women and is a major cause of abortion during pregnancy.
In this study 46 blood specimens were collected from pregnant women (aged between 20 and 35 years old) with complicated pregnancy states collected from Sohag university Hospital during the period from January 2012 to September 2013.
Specimens were tested by using serological technique, Enzyme-linked Immunosorbent Assay (ELISA)( this method depends on the presence of antibodies against the virus in the patient’s serum.), this test rapid and useful for the primary diagnosis for the presence of HCMV in the specimens.
According to this study we detect that, 37 patients were positive for IgG (80.4 %) and 9 negative (19.6%), while the 15 patients were positive for IgM (32.6%) and the other 31 patients were negative (67.4%)
Molecular analysis (PCR); was carried out for the detection of the presence of HCMV DNA in the specimens and that will confirm the results obtained from the serological test. The results for the PCR showed that; 2 out of 46 (4.3%) patients were positive while 44 out of 46 (95.7 %) patients were found HCMV negative.
Sensitivity & Specificity of ELISA IgG were 100 % & 20.6% respectively and of IgM was 100% & 70.5% respectively when compared with PCR.
According to the results of this study, PCR was used for the detection of Human Cytomegalovirus in serum specimens had high sensitivity ,effective and more specificity than serological methods.
CONCLUSION
1. Severe life-threatening complications of CMV infection in pregnant women may not be as rare as previously thought.
2. PCR detected CMV more sensitive and effective than ElISA in blood specimens submitted to the virology laboratories.
3. ElISA technique (IgG and IgM) is useful to detect CMV in primary infection and re – infection cases .
4. In case of primary maternal infection, parents should be informed about a 30% to 40% risk for intrauterine transmission and fetal infection, and a risk of 20% to 25% for development of sequelae postnatally if the fetus is infected.
5. The diagnosis of secondary infection should be based on a significant rise of IgG antibody titre with or without the presence of IgM and high IgG avidity. In cases of proven secondary infection, amniocentesis may be considered, but the risk–benefit ratio is different because of the low transmission rate.
6. Following a diagnosis of fetal CMV infection, serial ultrasound examinations should be performed every 2 to 4 weeks to detect sonographic abnormalities, which may aid in determining the prognosis of the fetus, although it is important to be aware that the absence of sonographic findings does not guarantee a normal outcome.
Recommendations:
1-The molecular assay should be used side by side with traditional laboratory methods for a rapid and an accurate detection of CMV in blood of pregnant women with repeated abortion.
2-Determined the different strains of CMV and sequencing these strains using molecular technique.
3-Using quantitative detection of CMV DNA by PCR as an indicator for the success of antiviral therapy, quantitative assays are preferred in order to monitor patient’s therapeutic responses.