Neurodevelopmental Outcome Following Congenital Cytomegalovirus Infection in Preterm Infants with Twin-to-Twin Transfusion Syndrome: A Case Report

Abstract

Twin-to-twin transfusion syndrome and conital cytomegalovirus infection bear the risk of brain damage. In the 27^th week of gestation of a twin pregnancy a Caesarean section was performed because of pathological cardiotocogram and Doppler ultrasonography of the second twin (recipient). Both infants presented with severe, persistent thrombocytopenia, elevated liver enzymes and direct hyperbilirubinemia. Primary congenital CMV infection was diagnosed. Both twins showed severe neuropathological symptoms, pathological aEEG with seizure activity and severe neurodevelopmental delay at corrected age of 12 months. The severity of brain pathology, the complex etiology, its consequence for neurotion with extreme prematurity make this case of special interest.

Zusammenfassung

Das feto-fetale Transfusionssyndrom und die kongenitale CMV-Infektion stellen zwei Krankheitsbilder in der Neonatologie dar, die mit einer potenziellen Schädigung des Gehirns und lebenslangen Entwicklungsstörungen einhergehen können. Neuropathologische Auffälligkeiten sind variabel und beinhalten Kalzifikationen, Zysten, sowie zerebelläre Fehlbildungen. Bei Frühgeborenen überwiegt die Zahl berichteter Fälle nach Reaktivierung und Übertragung von CMV durch die Muttermilch. Wir berichten einen Fall von extremer Frühgeburtlichkeit, kompliziert durch feto-fetales Transfusionssyndrom und kongenitale CMV-Infektion. Die Schwere der Hirnschädigung und Entwicklungsstörung machen diesen Fall besonders interessant.

Key words

preterm - congenital - cytomegalovirus - brain - neurodevelopmental - outcome

Schlüsselwörter

Frühgeborenes - Hirnschädigung - Entwicklung - Zytomegalovirus - konnatale Infektion

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