OC19.04: Callosal injuries in CMV fetopathy

Among the fetal brain anomalies described in cases of congenital infection, callosal insults are rarely cited in medical literature. The aim of this study was to describe the rate and pattern of callosal injury in CMV fetopathy. This retrospective study included fetuses with confirmed CMV-PCR, assessed in a single centre. Demographic data including maternal seroconversion info was collected. Dedicated US including neurosonography was performed, using high frequency probes, using TV route whenever feasible. Fetal brain biometry including callosal length and the CC/OFD ratio was performed. Length below the 5th centile or morphological abnormalities were considered abnormal. Brain and body morphology was thoroughly assessed, and any abnormal finding reported. 72 patients were included in our cohort. In 76% infection occurred in the 1stT or periconceptional. In 12 patients the exact time of infection was inconclusive, including 2 cases of secondary infection. In 34.7% a callosal anomaly was observed and it was never isolated; Other findings were: periventricular hyperechogenicity (PVHE) 55.5%, calcifications 52%, ventriculomegaly 33%, periventricular pseudocysts 31.4%, occipital cysts 22.2%, echogenic ganglionic eminence 30.5%. LSV 26.4%, sulcation abnormalities 22.2%, cerebellar findings 18% and HC below -2SD 18%. In 19 cases the CC was short, 4 had calcifications. In 1 case the insult was severe and in 1 case the CC was absent. The most common association with CC insult was PVHE (56%) and calcifications (52%). Although not referred as a classic brain structure affected by CMV infection, the CC was injured in one-third of our patients, including cases of late infection. Especially in the presence of a single finding, considered of mild prognostic significance, the CC should undergo assessment and follow-up throughout pregnancy, as the association with an insult would imply in a worse prognosis and enhanced risk of neurodevelopmental impairment.