Cytomegalovirus infection during pregnancy: cross-sectional survey of knowledge and prevention practices of healthcare professionals in French-speaking Switzerland.

BACKGROUND: Lack of Cytomegalovirus (CMV) knowledge among healthcare professionals has been proven to be the main threat to pregnant women's awareness, preventing them from reducing the risk of infection. The aims of this study were to assess the knowledge and practices of French-speaking Swiss perinatal professionals in terms of CMV prevention, as well as the sociodemographic-professional factors that influence them. METHODS: This observational study used a cross-sectional design to collect data-via an anonymous electronic questionnaire in French distributed to gynecologists-obstetricians, general practitioners and midwives via various channels: e-mails and social networks of partner centers, professional associations, and conferences. The 41-item questionnaire collected data on sociodemographic and professional characteristics, general CMV knowledge, national recommendation knowledge and prevention practices. Univariable and multivariable analyses were performed. RESULTS: A total of 110 gynecologist-obstetricians, 5 general practitioners and 226 midwives participated in the study. While more than 80% of practitioners were familiar with protective hygiene measures, significant gaps were highlighted concerning the transmission routes, as well as the signs of short- and long-term congenital CMV infection. Regarding practice, 63.3% of participants provided information on CMV to their patients, mainly during the first antenatal visit. Among those who did not, lack of knowledge and forgetfulness were the two main reasons cited. Concerning systematic screening, 45.7% of participants offered it to their patients, and 37.3% only offered it to "at risk" groups. The existence of national guidelines on CMV was known by 62.0% of participants. Multivariable analysis revealed that working as a gynecologist-obstetrician was independently associated with higher score of preventive practices, while performing ultrasound or preconception consultations was independently associated with a higher score of general CMV knowledge, and working in a university hospital was independently associated with a higher score of Swiss recommendation knowledge. A level of training higher than the basic medical or midwifery diploma and participation in fetal medicine symposia both promote a higher score of CMV knowledge and prevention practices in line with current recommendations. CONCLUSION: This study confirms the significant gaps in CMV knowledge among French-speaking Swiss caregivers along with the heterogeneity of their prevention practices. To raise awareness among pregnant women and reduce the burden of congenital CMV infections, improving professional knowledge through access to specific training and standardizing practices should be a national priority.

Visualización de la anatomía fetal por ecografía prenatal entre las semanas 11-13+6 / Visualising foetal anatomy by prenatal ultrasound between weeks 11-13+6

Objetivo. Comunicar la capacidad de visualización de estructuras anatómicas fetales durante la ecografía habitual de valoración de marcadores entre las semanas 11 y 13+6 de gestación en la Unidad de Ecografía del Centro Gutenberg de Málaga. Métodos. Evaluamos 990 pacientes que consultaron para valoración del cálculo de riesgo para trisomía 21, de las cuales 652 fueron utilizadas para el análisis. En 20 minutos realizamos la evaluación del grosor de la translucencia nucal y marcadores ecográficos adicionales, además de intentar valorar las principales estructuras anatómicas fetales, incluido el corazón, por vía abdominal o transvaginal según preferencia del operador. Resultados. El índice de masa corporal materno medio fue de 23,9; la media de la edad gestacional fue de 12 semanas; la longitud craneocaudal media fue de 62,6mm y la translucencia nucal se consideró por encima del percentil 95 en el 8,6% de los casos. Obtuvimos más del 90% de visualización (normal o con malformación) de cabeza y cerebro, cara, cuello, tórax, abdomen, extremidades y columna. Sin embargo, el corazón y los riñones ofrecieron mayor dificultad con una identificación global del 76 y 67% respectivamente. La mayoría del las exploraciones se realizaron con abordaje abdominal. Conclusiones. Es posible visualizar la anatomía fetal en más del 90% de los fetos, con más facilidad y éxito en la semana 13. La valoración del corazón y los riñones presentó siempre más dificultades. Destacamos la importancia de evaluar la anatomía fetal junto a los marcadores de aneuploidía en las semanas 11-13+6(AU)

Objective. To report the feasibility of identifying the foetal anatomy during the routine 11 to 13+6 weeks scan in the Ultrasound Unit at the Gutenberg Centre in Malaga, Spain. Methods. We examined 990 patients who attended our Unit to carry out the ultrasound screening for chromosomal abnormalities and risk assessment for trisomy 21, and 652 were included for the analysis. We measured the nuchal translucency thickness and additional ultrasound markers during the 20minutes allocated. In addition, we tried to visualise the main foetal anatomic structures, including the heart. The scans were done abdominally or by transvaginal approach, according to the preference of the operator. Results. The mean maternal body mass index was 23.9 and the mean gestation was 12 weeks; the mean crown rump length was 62.6mm and the nuchal translucency thickness was above the 95th centile for gestation in 8.6% of the foetuses. Visualisation of the foetal anatomy was successful in 90% of cases, classified as normal or abnormal, in most of the structures. However, the heart and kidneys were more difficult to identify with confidence and success was achieved in 76% and 67%, respectively. The large majority (93%) of the scans were performed abdominally. Conclusions. It is feasible to visualise the foetal anatomy in more than 90% of the cases during the routine first trimester scan. The heart and the kidneys remained the most difficult. We would like to stress the importance of the anatomical survey in the 11 to 13+6 weeks scan, in addition to the ultrasound markers assessment for the screening of chromosomal defects(AU)