HEALTH – Amandine was four months pregnant when she found out she had been infected with cytomegalovirus. “A fetal MRI at the end of pregnancy showed that Hector (her son, editor’s note) had a great many cerebral damage, we decided for his well-being to terminate the pregnancy,” she says.
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If for most of us, the month of June evokes above all the music festival, the summer solstice, end of the school year, exams, competitions … It is also the month of awareness of cytomegalovirus, the CMV.
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Still largely unknown today, cytomegalovirus is a virus of the same family as that of sore, of the’genital herpes or the varicella. CMV infection is most often mild, may go unnoticed, and affects approximately 50% of the population. But it can also have serious consequences when it affects a pregnant woman.
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A patient infected with CMV only transmits it in about 30% of cases to the fetus. When this is the case, this fetus can develop serious malformations, such as “hearing disorders and in the most serious forms an intellectual and motor deficit”, describes Professor Yves Ville, obstetrician gynecologist, specialist in surgery. fetal and fetal medicine, contacted by The HuffPost.
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Not systematic screening
Despite the risk, many women fall through the cracks of screening. In addition to the general public’s ignorance, from one practitioner and from one establishment to another, information, screening and follow-up vary.
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This is for example what Karen confides to us: “I discovered my infection around 17 weeks of pregnancy, after asking to be tested”. For her part, Anne-Hélène, three children, including Hermance, polyhandicapée after having was infected with CMV during her mother’s pregnancy, was even advised against screening. “While I was a few weeks pregnant, I saw a document about CMV lying around in my lab. I asked my obstetrician to do the test to find out if I was immune and he replied that it was useless, that there was no risk and that if I was afraid of the slightest risk it was better not to have children… a nice patriarchal answer, no? That day he chose for me! ”She laments.
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So, according to Professor Yves Ville, serological screening for CMV should “be carried out in the first trimester to transform a risk into an opportunity”. Professor Picone agrees, a test systematic screening should even be offered. But this is not the opinion of the High Authority of Health who in 2004 concluded that screening was not justified during pregnancy. However, HAS recommended that information on universal hygiene measures should be given to pregnant women.
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Within his practice, Professor Picone favors late screening, to rule out risks or postpone examinations (ultrasound, amniocentesis, MRI) and treatments, which can contribute to increasing the worries and anxieties of future parents, already stressed by pregnancy. in herself.
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“This protocol may seem cumbersome, even anxiety-provoking for some patients, but it is also a risk to be taken to avoid dramatic situations”, he explains, also an expert in the management of infections during pregnancy and founding president. of Infections in Pregnancy Research Group (GRIG).
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Non-significant symptoms
In addition to this stress factor, and the lack of consensus from the medical profession, the difficulty of screening for CMV also lies in recognizing these symptoms, which are often insignificant. “Most often there is none in pregnant women. It can be a flu-like syndrome or a ‘liver attack’ ”, notes Professor Yves Ville, who operates on fetuses. in utero.
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In fact, only examinations can highlight the possible sequelae on the fetus.
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If there is screening, and once CMV is detected, several options are possible. “It is only justified to offer treatment if the maternal infection occurred in the first trimester of pregnancy. The treatment in question is mainly used in case of herpes, but in high doses, it is effective in preventing infection of the fetus or reducing its severity. It is not toxic to the fetus ”, explains Professor Ville.
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In other cases, medical termination of pregnancy is recommended and offered to parents.
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Thanks to social networks and communications in some health centers, things are changing, and good practices on how to avoid it are starting to be disseminated.
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The best prevention? Information
Thus, in his work Midwife, tell me everything, (Ed. Leduc) and The postpartum dream life, published by Larousse editions, midwife Anna Roy, herself affected by this virus, believes that the best prevention against CMV infection is the observation of simple hygiene rules, and that should take all women pregnant.
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This is what she does naturally with her patients. “This virus is very fragile and, most of the time, protecting yourself from it is very simple, by observing very strict hygiene”. And this especially if a pregnant woman is not immune to CMV and is in contact with children under three years old who attend a community (crèche, daycare). In this case, it is better (as well as your spouse) ”avoid kissing them on the mouth, wash your hands well with soap after taking care of them (especially after changing the diapers) or use a hydroalcoholic solution, wash regularly their toys, not to taste the bottles or suck on their cutlery, not to share toiletries, or even to avoid taking a bath with them (risk of contamination by urine) ”, she concludes.
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This is also agreed by Professor Picone, who adds that despite the information increasingly, perhaps too much during pregnancy, it is very important to inform future parents of the risks of infection at CMV. “It has been almost 20 years that several times a year, we intervene on the subject of CMV, to train the practitioners, we communicate regularly on this virus, but at the national level, it would be necessary to be able to promote the preconception consultation, when the parents emit a desire for a child. CMV infection will then be evoked, from symptoms to risks, including treatment and support, ”he says.
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Karen, for her part, now wishes to commit to obtaining systematic screening of pregnant women. “I discovered a world with this infection: difficult understanding of analyzes by parents, lack of information from doctors, even the desire not to engage in an information process due to ignorance of the virus”.
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Amandine, meanwhile, still wonders if her son could have been born healthy if she had been informed of the risks earlier and if early detection had been recommended.
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Anne-Hélène, who describes her impossibility of choosing screening as “an indescribable violence” and a “patriarchal” position taken by her practitioner who refused her this screening, created the association in 2016 CMV. She campaigns for the free choice of parents to be screened.
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For further:
You can Download the informative poster on the CMV, created by the website of theassociation CMV.
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See also on The HuffPost: “I am mistreating”: the cry from the heart of this midwife who makes a non-negotiable appeal: a midwife for every woman
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