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This encouraging early data has been followed by two further studies, both confirming fetal benefit with administration of CMV HIG following confirmation of fetal infection.
Confirmation of fetal infection requires an amniocentesis.
The optimal frequency of ultrasound surveillance is unknown, but ultrasound examinations are generally performed every 2-4 weeks following confirmation of fetal infection.
Similarly, in this study, it is possible that some indications could be termed inappropriate e.g. for CS conducted for fetal distress if at birth there was no confirmation of fetal distress or incorrectly diagnosed CPD.
These mothers were referred to the prenatal service at HC/UFG to continue the treatment initiated with spiramycin throughout pregnancy, once the presence of IgM in the peripheral blood of pregnant women, independent confirmation of fetal infection.
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Confirmation of the fetal distress by fetal scalp pH estimation is not a practice at BMC thus a large window of validity for the diagnosis may exist.
Other reasons mentioned by the respondents for prenatal ultrasound scans were determination of number of fetuses and fetal age, confirmation of placenta position and fetal presentation.
Confirmation of pregnancy viability (presence of fetal cardiac activity) and diagnosis of fetal presentation (head or buttock in the maternal pelvis) are the first essential components of ultrasound assessment in obstetrics.
The rates of biochemical pregnancy loss (positive β-hCG only without development of a gestational sac) and early clinical pregnancy loss (pregnancy loss up to 12 weeks of gestation after confirmation of a clinical pregnancy with fetal cardiac activity at 6 7 weeks of gestation) also did not differ between groups (Table III).
Confirmation of an association between lesions and presence of the organism is therefore mandatory to confirm C. burnetii as the cause of fetal disease – a demand generally applied in diagnostic reproductive pathology.
13,16,19 Our confirmation of early calcium accumulation in DMD fetal muscle is important for determination of the pathophysiological mechanisms, and also for defining the optimal time-point for initiation of treatment.
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