Cytomegalovirus-associated acute hydramnios treated by amniocentesisand maternal indomethacin

摘要

A 22-year-old pregnant woman noticed arapid increase of abdominal growth, uterine tenderness andirregular contraction, for which she hospitalized at 25 weeksof gestation. An ultrasound examination demonstrated a singlefetus with normal anatomy and massive hydramnios. Serialtherapeutic amniocentesis was performed for relief of maternalsymptoms and indomethacin compress was initiated. Both thematernal and amniotic fluid IgM were positive for cytomega-lovirus (CMV). Maternal compress indomethacin was discon-tinued at 32 weeks. Cesarean section was performed due to fetaldistress at 34 weeks of gestation. A female infant was deliveredand the neonatal examination was within normal limits withurine culture positive for CMV. At 1 year of age the child wasdeveloping normally with normal hearing and no clinicalsequelae of intrauterine CMV infection. We postulate that serialand large volume reduction of amniotic fluid by amniocentesisand compress indomethacin in our case interrupted the naturalcourse and provided sufficient time for the fetus to recover fromthe acute phase of viral infection.