Detection of cytomegalovirus, herpes virus simplex, and parvovirus b19 in spontaneous abortion placentas.

OBJECTIVE: This study aims to investigate the presence of Cytomegalovirus (CMV), herpes virus simplex (HSV), and parvovirus B19 (PVB19) in the placental tissue of patients who underwent abortions without an otherwise-defined aetiology. STUDY DESIGN: This cross-sectional study was conducted in a high-risk obstetric maternity facility at a University Hospital in Belo Horizonte, Brazil, from January 2013 to December 2015. We included placenta samples obtained from spontaneous abortions of unknown aetiology. Seventy placenta samples were identified and were classified according to histopathological characteristics. All samples were analysed using immunohistochemistry and polymerase chain reaction for CMV, PVB19, and HSV. The clinical variables were collected from the medical records of patients to verify the association of infection with villitis. The patients were divided into the following groups: I) with villitis (n = 28) and II) without villitis (n = 42). METHODS: Immunohistochemistry used monoclonal anti-CMV antibody (NCL-CMVpp65, Leica Biosystems, Wetzlar, Germany), anti-PVB19 antibody (NCL-PARVO, Leica Biosystems, Wetzlar, Germany), and anti-HSV1/HSV2 antibodies (NCL-HSV-1 and HSV2, Leica Biosystems, Wetzlar, Germany). The data were analysed using the Statistical Package for Social Sciences (SPSS Inc, Chicago, IL) 19.0. RESULTS: Viral agents were detected in five patients (7.14%) in the villitis group. Three patients were positive for CMV, one for PVB19, and one for HSV type 2. Foetal and maternal complications were significantly higher in the group with villitis compared with those in the group without villitis (p = .002). CONCLUSIONS: The prevalence of transplacental viral infections as a cause of spontaneous abortion should be considered high in the placenta with villitis. Thus, this study highlights the need for developing diagnostic tests to clarify the aetiology of abortion and foetal loss.

Estudo transversal do perfil das infecções congênitas atendidas entre 2012 e 2014 em um centro de referência em Belo Horizonte, Minas Gerais / Cross-sectional study of clinical and laboratorial aspects of congenital infections attended at a reference Center in Belo Horizonte, MG, 2012-2014

Introdução: as infecções congênitas são resultantes da transmissão vertical de microrganismos de gestantes infectadas para seus conceptos. Apesar dessas infecções, em geral, cursarem com pouca ou nenhuma manifestação clínica nas gestantes, a infecção fetal pode trazer morbimortalidade perinatal e na infância. Objetivo: identificar a prevalência das infecções congênitas encaminhadas ao Centro de Referência e Treinamento em Doenças Infecciosas e Parasitárias Orestes Diniz (CTR/DIP Orestes Diniz) e avaliar os métodos laboratoriais usados para o diagnóstico. Métodos: estudo transversal realizado em ambulatório de referência em doenças infecciosas, a partir de coleta de dados de prontuários de crianças com diagnóstico suspeito de infecção congênita. A confirmação diagnóstica baseou-se em testes sorológicos ou de biologia molecular, além de descrição de sintomatologia da criança. Resultados: um total de 513 crianças foram identificadas, sendo que 41,3% tiveram o diagnóstico confirmado, a maioria foi de toxoplasmose (45,35%) e sífilis (15,98%). Entre as crianças com diagnóstico confirmado, 28,85% apresentaram manifestações clínicas, enquanto que no grupo com diagnóstico indeterminado ou suspeito o percentual foi de 16,38%. As principais manifestações identificadas foram acometimento do sistema nervoso central (n=39) e alterações visuais (n=30). Conclusão: a confirmação de infecção foi definida em aproximadamente metade dos pacientes avaliados e a maioria das crianças foi assintomática ao nascimento. O pré-natal de qualidade e a propedêutica e tratamento precoce das crianças identificadas podem reduzir o impacto dessas infecções no nosso meio.(AU)

Introduction: congenital infections are results of microorganisms transmitted to the fetus by the infected pregnant. Most newborn infants infected during pregnancy or labor have no sings of congenital disease. However, these infections may cause perinatal and infancy morbidity and mortality. Objective: to determine the prevalence of congenital infections in newborns and infants attended at the CTR/DIP Orestes Diniz (Centro de Treinamento e Referência em Doenças Infecciosas e Parasitárias Orestes Diniz) and to analyse the laboratorial methods used for diagnosis of congenital disease of assisted children. Methods: cross-sectional study conducted in an Infectious Diseases Reference Center where it was evaluated the charts of infants with suspected congenital infection. Diagnosis confirmation was based on serological tests, molecular biology and signs and symptoms described in the charts. Results: A total of 41,3% of the 513 children identified have had a defined diagnosis. Most of them had toxoplasmosis (45,35%) and syphilis (15,98%). Clinical manifestations was observed in 28,85% of children with defined diagnosis of congenital infection, and in 16,38% of children with uncertain diagnosis. Central Nervous System (n=39) and ocular (n=30) manifestations were the most frequent findings. Conclusions: Defined diagnosis was possible in about half of cases and most of them were asymptomatic at birth. An appropriate prenatal care and early diagnosis and treatment of congenital infections may reduce the impact of disease in the population.(AU)