Byline: Zion J. Hagay, Galya Biran, Asher Ornoy, E.Albert Reece Keywords: Congenital cytomegalovirus infection; prenatal diagnosis; serologic tests; mass screening Abstract: OBJECTIVE: The purpose of this study was to review the accuracy of current tests used for the diagnosis of in utero cytomegalovirus infection and to discuss the potential value of preconceptional and postconceptional screening programs for prevention of congenital infection. STUDY DESIGN: A computer-assisted search was performed for relevant English language publications between 1987 and 1994. We identified 119 cases of suspected intrauterine cytomegalovirus infection in which either amniotic fluid or fetal blood had been analyzed antenatally. RESULTS: Congenital cytomegalovirus infection affects 0.5% to 2.5% of all newborns. The rate of transmission to the fetus after primary infection during pregnancy ranges from 15% to 50%. Of the fetuses infected in utero, 10% exhibit congenital cytomegalovirus syndrome. Evaluation of 119 cases of suspected infection has shown that polymerase chain reaction and cultures of amniotic fluid are the most reliable tests for prenatally determining the presence of viral particles. However, efficacy of routine antenatal screening in reducing the rate of fetal disease is limited. CONCLUSION: It is concluded that at present the accuracy of tests used for the diagnosis of in utero cytomegalovirus infection is undetermined. Serologic screening of all pregnant women is of limited value and at present is not recommended. (AM J OBSTET GYNECOL 1996;174:241-5.) Author Affiliation: Rehovot and Jerusalem, Israel, and Philadelphia, Pennsylvania Article History: Received 15 December 1994; Revised 24 March 1995; Accepted 4 May 1995 Article Note: (footnote) [star] From the Departments of Obstetrics and Gynecology, Kaplan Hospital,a the Jerusalem Institute of Child Development and Laboratory of Teratology, The Hebrew University, Haddasah Medical School, b and Temple University School of Medicine. , [star][star] Reprint requests: Zion J. Hagay, MD, Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel., a 0002-9378/96 $5.00 + 0 6/1/66061