Congenital cytomegalovirus infection in 1 twin with a pericardial effusion: A case report

BACKGROUND: Congenital fetal damage related to cytomegalovirus (CMV) infection is largely attributable to maternal primary infection. Twin fetuses may react differently to the same maternal influences. CASE: A woman had a sonographically documented fetal pericardial effusion in 1 twin at 33 weeks of gestation. The workup for maternal infection and fetal structural anomaly was negative except for positive CMV IgG in the maternal serum. Cesarean section was performed due to fetal distress. After delivery, CMV viral antigenemia was found in 1 twin with petechiae, thrombocytopenia, hepatosplenomegaly and ventriculomegaly. The other twin was not infected and in stable condition. CONCLUSION: Since twin fetuses simultaneously exposed to the same maternal influence had a completely different outcome, maternal factors play a limited role in influencing CMV transmission.