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South Australian Perinatal Practice Guideline 

Cytomegalovirus  
  Department for Health and Wellbeing, Government of South Australia. All rights reserved. 

INFORMAL COPY WHEN PRINTED  Page 1 of 17 

Public-I4-A4 
 
 

Note:

This guideline provides advice of a general nature.  This statewide guideline has been prepared to promote and 
facilitate standardisation and consistency of practice, using a multidisciplinary approach.  The guideline is based 
on a review of published evidence and expert opinion.  

Information in this statewide guideline is current at the time of publication.  

SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site 
and does not sponsor, approve or endorse materials on such links. 

Health practitioners in the South Australian public health sector are expected to review specific details of each 
patient and professionally assess the applicability of the relevant guideline to that clinical situation. 

If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must 
document in the patient s medical record, the decision made, by whom, and detailed reasons for the departure 
from the guideline. 

This statewide guideline does not address all the elements of clinical practice and assumes that the individual 
clinicians are responsible for discussing care with consumers in an environment that is culturally appropriate 
and which enables respectful confidential discussion. This includes: 

  The use of interpreter services where necessary, 
  Advising consumers of their choice and ensuring informed consent is obtained, 
  Providing care within scope of practice, meeting all legislative requirements and maintaining 

standards of professional conduct, and  
  Documenting all care in accordance with mandatory and local requirements 

Note: The words woman/women/mother/she/her have been used throughout this guideline as most pregnant 
and birthing people identify with their birth sex. However, for the purpose of this guideline, these terms include 
people who do not identify as women or mothers, including those with a non-binary identity. All clinicians should 
ask the pregnant person what their preferred term is and ensure this is communicated to the healthcare team. 

 
Explanation of the aboriginal artwork: 
The Aboriginal artwork used symbolises the connection to country and the circle shape shows the strong relationships amongst families and the Aboriginal culture. The 
horse shoe shape design shown in front of the generic statement symbolises a woman and those enclosing a smaller horse shoe shape depicts a pregnant woman. The 
smaller horse shoe shape in this instance represents the unborn child. The artwork shown before the specific statements within the document symbolises a footprint and 
demonstrates the need to move forward together in unison. 
 

 

     

 

 

 

 

 

 

Purpose and Scope of Perinatal Practice Guideline (PPG) 

The Cytomegalovirus Management PPG has been developed to provide clinicians with information 
for the management of cytomegalovirus infection in pregnancy and thus reduce mother to child 
transmission of the virus. It includes details regarding the indications for testing, referral, diagnosis 
and counselling. Suggested newborn assessment and follow-up management is also described  

Australian Aboriginal Culture is the oldest living culture in the world yet 
Aboriginal people continue to experience the poorest health outcomes when 
compared to non-Aboriginal Australians. In South Australia, Aboriginal women are 
2-5 times more likely to die in childbirth and their babies are 2-3 times more likely to 
be of low birth weight.  The accumulative effects of stress, low socio economic 
status, exposure to violence, historical trauma, culturally unsafe and discriminatory 
health services and health systems are all major contributors to the disparities in 
Aboriginal maternal and birthing outcomes. Despite these unacceptable statistics, 
the birth of an Aboriginal baby is a celebration of life and an important cultural 
event bringing family together in celebration, obligation and responsibility. The 
diversity between Aboriginal cultures, language and practices differ greatly and so 
it is imperative that perinatal services prepare to respectfully manage Aboriginal 
protocol and provide a culturally positive health care experience for Aboriginal 
people to ensure the best maternal, neonatal and child health outcomes. 

 



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Flowchart 1 - Maternal Diagnosis 

 

 

  



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Flowchart 2 - Antenatal Management of Primary Maternal CMV 

infection 

 

  



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Flowchart 3   Risk Estimates of Fetal Transmission 

 



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Flowchart 4   Neonatal Diagnosis and Management 

 

  



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Table of Contents 

 

Purpose and Scope of Perinatal Practice Guideline (PPG) .................................................. 1 

Flowchart 1 - Maternal Diagnosis ........................................................................................ 2 

Flowchart 2 - Antenatal Management of Primary Maternal CMV infection ........................... 3 

Flowchart 3   Risk Estimates of Fetal Transmission ............................................................ 4 

Flowchart 4   Neonatal Diagnosis and Management ........................................................... 5 

Summary of Practice Recommendations ............................................................................. 7 

Abbreviations ....................................................................................................................... 8 

Definitions ........................................................................................................................... 8 

Introduction ......................................................................................................................... 9 

Background ......................................................................................................................... 9 

Transmission ....................................................................................................................... 9 

Prevention ......................................................................................................................... 10 

Diagnosis .......................................................................................................................... 10 

Testing criteria ............................................................................................................... 10 

Clinical presentation ................................................................................................... 10 

High risk groups for primary CMV ............................................................................... 10 

Testing ........................................................................................................................... 10 

Management of CMV Infection .......................................................................................... 11 

Infection precautions ...................................................................................................... 11 

Maternal counselling ...................................................................................................... 11 

Fetal risk assessment .................................................................................................... 12 

Ultrasound .................................................................................................................. 12 

Amniocentesis ............................................................................................................ 12 

Congenital CMV management ........................................................................................... 13 

Maternal primary CMV infection ..................................................................................... 13 

Maternal non-primary CMV infection (reactivation or reinfection) ................................... 13 

Management of the Newborn ............................................................................................ 13 

Laboratory investigations ............................................................................................... 13 

Investigations ................................................................................................................. 13 

Follow up ....................................................................................................................... 14 

Future Pregnancies ........................................................................................................... 14 

Supporting Documents ...................................................................................................... 14 

Additional Resources ......................................................................................................... 14 

References ........................................................................................................................ 15 

Acknowledgements ........................................................................................................... 16 

 

 



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Summary of Practice Recommendations  

? Most primary maternal CMV infections are asymptomatic1. 

? Advise all pregnant women about hygiene measures to reduce the risk of CMV infection 
including: 

o Good handwashing after handling articles contaminated with saliva, urine, secretions   
particularly after changing nappies, 

o Not sharing drinks, food, cups, water, toothbrushes and utensils with young children (&lt; 3 
years of age),  

o Avoiding contact with the saliva of young children (&lt;3 years of age), 

o Avoiding saliva when kissing a child (&lt;3 years of age), 

o Not sharing a dummy/soother with a child, 

o Regular cleaning of toys and counter tops and other surfaces with simple detergent6. 

? Risk of vertical transmission to the fetus after maternal primary CMV infection increases with 
increasing gestation. However, risk of severe fetal impairment is rare when infection occurs after 
the first trimester1. 

? Adherence to standard precautions is sufficient when caring for a woman and baby suspected 
or confirmed CMV infection. Standard precautions are used when there is the potential for 
contact with blood or body fluids from any patient regardless of infectious status. Personal 
protective equipment such as gloves, gowns/aprons, masks and face shields are used to 
protect the healthcare worker from unprotected exposure to blood or body fluids, and to prevent 
the transmission of infection to other patients.  

? Offer CMV testing for all women who have frequent or prolonged contact with large numbers of 
young children (ie. Childcare workers and mothers of children in childcare) using serology (CMV 
IgG)21 

? The pregnant woman should be tested for CMV infection if they have a history suggestive of 
CMV illness, exposure to known CMV infected individual, are immunocompromised or have 
suggestive abnormalities on routine antenatal ultrasound6. 

? Specific clinical, laboratory and radiological assessment of the baby of a woman who has CMV 
infection during pregnancy is required. CMV screening in the pregnant woman should include 
IgG and IgM antibodies. Further CMV avidity testing may be required. 

? The pregnant woman with CMV requires specialist counselling.  Treatment measures for the 
prevention or treatment of congenital CMV are under investigation, and are still of uncertain 
effectiveness. Timely referral is paramount4. 

? Fetal diagnosis of CMV is best achieved by a combination of fetal ultrasound and 
amniocentesis5  

? Current information indicates that the risk of congenital CMV infection after primary maternal 
CMV infection remains elevated for up to 12 months post pregnancy3.This may have 
implications for family planning. 

? The CMV infected, asymptomatic baby of a woman who has CMV infection during pregnancy 
also requires paediatric follow-up for 2 years3. 

  



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Abbreviations   

AABR Automated Auditory Brainstem Response 

AF Amniotic Fluid 

AFI Amniotic Fluid Index 

ASID Australasian Society for Infectious Diseases 

CMV Cytomegalovirus 

CT Computed Tomography scan 

IgG Immunoglobulin G 

IgM Immunoglobulin M 

IUGR Intra-Uterine Growth Restriction 

MRI Magnetic resonance imaging 

mL Millilitre/s 

PCR Polymerase chain reaction 

PPV Positive Predictive Value 

Definitions 

Amniocentesis A process in which amniotic fluid is sampled using a hollow needle inserted 
into the uterus, to screen for abnormalities in the developing fetus 

Chorioretinitis Inflammation of the choroid, which is a lining of the retina deep in the eye 

Counselling 

 

Voluntary discussions aimed at assisting the individual to recognise and better 
manage or reconcile problems affecting their life 

Hepatomegaly Abnormal enlargement of the liver 

Hydrocephalus  

 

A condition in which fluid accumulates in the ventricles of the brain, which may 
cause damage to the brain 

Hydrops A condition that develops if a fetus become severely anaemic, is fluid 
overloaded, or goes into heart failure.  Large amounts of fluid build-up in the 
baby's tissues and organs. It is diagnosed when there are at least 3 of the 
following on ultrasound examination - 1) fluid around the heart, 2) fluid around 
the lungs, 3) fluid around the gut, 4) swelling of tissue under the skin. 

Intrauterine 
growth restriction 

 

Otherwise called  small-for-gestational age  whereby the estimated fetal 
weight measures &lt; 10th percentile on ultrasound. This diagnosis does not 
necessarily imply pathologic growth abnormalities, and may simply describe a 
fetus at the lower end of the normal range 

Microcephaly An abnormal smallness of the fetus  head; a congenital condition associated 
with incomplete brain development 

Oligohydramnios 

 

Refers to a low level of amniotic fluid during pregnancy. It is defined by an 
amniotic fluid index that is below the 5th centile for the gestational age. 

Polyhydramnios Excessive amniotic fluid present during pregnancy. Is diagnosed if the 
deepest vertical pool is more than 8 cm or amniotic fluid index (AFI) is more 
than 95th percentile for the corresponding gestational age 

 

  



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Introduction 

? Most primary CMV infections are asymptomatic 

? The incidence of primary cytomegalovirus (CMV) infection in pregnancy in Australia is estimated 
to be 6 per 1,000 pregnancies, with 0.2   2.2% of live births affected2. 

? Most pregnant women with primary CMV infections are asymptomatic3.  

? CMV is the commonest congenital infection with medical significance3. 

? Risk of vertical transmission to the fetus after maternal primary CMV increases with increasing 
gestation. Severe fetal impairments are rare when infection occurs after the first trimester4. 

? In Australia CMV causes abnormalities (evident in 200   600 babies each year), such as:  

o Deafness 

o Intellectual impairment 

o Hepatitis  

o Pneumonitis  

o Blindness6.  

Background 

? Cytomegalovirus (CMV) is a beta herpes virus with worldwide distribution.  

? After primary infection, the virus remains present in the resting or latent phase (indicated by 
CMV specific IgG seropositive result). 

? The virus can reactivate spontaneously or in conditions where immunity is suppressed, such as 
in pregnancy. 

? Primary infection is limited to women who are CMV IgG negative and seroconvert during 
pregnancy, or periconceptually. CMV infection leads to the production of CMV-specific IgM 
production which can persist for up to 2-3 years. 

? Reactivation occurs when CMV is isolated in a woman known to have CMV IgG7. 

Transmission 

? Mother to fetus: vertical transmission after maternal primary CMV infection increases with 
advancing gestation, from approximately 21% in the preconception period, to 66% in the 3rd 
trimester1. 

? Importantly, risk of fetal injury after primary infection decreases significantly after the first 
trimester:  

o Periconception 29%  

o First trimester 19%  

o 2nd trimester 1%  

o 3rd trimester &lt;1%1 

? Therefore, the highest risk of fetal injury follows primary infection in the periconception period or 
first trimester, being in the order of approximately 6-7% (risk of transmission x risk of fetal 
insult)1. 

? If infected in the first trimester, the newborn will be symptomatic in approximately 9% of cases, 
with much lower injury rates of ?1% following periconception or 2nd/3rd trimester infection1. 

? In pregnancy CMV is transmitted by: 

o handling articles contaminated with saliva, urine, secretions   particularly after changing 
nappies, 

o sharing drinks, food, cups, water, toothbrushes and utensils with young children (&lt; 3 
years of age) during pregnancy, 

o contact with the saliva of young children (&lt;3 years of age), 

o saliva when kissing a child (&lt;3 years of age), 

o sharing a dummy/soother with a child, 



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o toys, counter tops and other surfaces that have not been regularly cleaned with simple 
detergent 6. 

? Infection with CMV can also occur via: 

o Breast milk, 

o Sexual contact, 

o Blood transfusions (Negligible risk associated   less than 1 in 1million)22 

Prevention 

? All pregnant women should be advised to adopt simple hygiene precautions, including: 

o Good handwashing after handling articles contaminated with saliva, urine, secretions   
particularly after changing nappies, 

o Not sharing drinks, food, cups, water, toothbrushes and utensils with young children (&lt; 3 
years of age) during pregnancy, 

o Avoiding contact with the saliva of young children (&lt;3 years of age), 

o Avoiding saliva when kissing a child (&lt;3 years of age), 

o Not sharing a dummy/soother with a child, 

o Regular cleaning of toys, counter tops and other surfaces with simple detergent6. 

See SA Health Prevent CMV during pregnancy brochure 

Diagnosis 

Testing criteria  

Clinical presentation 

? Women with CMV may present with a mononucleosis-like syndrome; flu-like symptoms, 
infection of the gastrointestinal tract, abnormal liver function, or rashes10. 

High risk groups for primary CMV 

? Child care workers (incidence of 12% per annum)3.  

? Parents with a child in child care (incidence of 20   30 % per annum) 3. 

 
Universal routine serological screening for CMV in pregnancy is currently not recommended 5 

Targeted screening based on clinical presentation suggestive of CMV, or risk groups above 
(frequent, prolonged exposure to children in child care) is recommended6.  

Aboriginal women should be referred to an Aboriginal Healthcare Work to support their care when 
discussing testing criteria and testing 

Testing 

? Obtain maternal serology for the detection of CMV antibodies,  

? IgG positive, IgM negative indicates past exposure, 

? IgG negative or positive with IgM positive requires further testing in 2-4 weeks, (Interpretation of 
CMV IgM results in pregnancy requires specialist virological interpretation   see ASID guideline 
for more detail:  https://www.asid.net.au/documents/item/368     

? Maternal Fetal Medicine and paediatric infectious disease subspecialist consultation should be 
sought (both with 24 hour referral availability at the WCH) 

? Seroconversion (IgG negative to positive) or a significant rise in IgG indicates a recent primary 
CMV infection, 

? The pregnant woman with suspected CMV infection should have CMV serology testing for IgG 
and IgM, and IgG avidity if CMV IgG and IgM are positive4. Consider CMV serology testing on 
previous antenatal serology samples often obtained in the first or second trimester of pregnancy 
(these antenatal blood samples are usually kept for 12 months). 





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? Avidity testing for CMV IgG can indicate the timing of primary infection with respect to the 
pregnancy.15 Low CMV IgG avidity is an accurate indicator of primary infection within the 
preceding 3 to 4 months, whereas high avidity excludes primary infection within the preceding 3 
months.  
   

? Serologic testing for cytomegalovirus is recommended for the following women in pregnancy: 

o history suggestive of CMV illness 

o exposure to known CMV infected individual or blood product 

o immunocompromised women 

o abnormalities on routine antenatal ultrasound (usually at 18 - 20 weeks)3. 

? Recent cost effectiveness analysis taking into account new treatment options for CMV have 
triggered debate on the possible future of routine CMV screening16(2) 

Management of CMV Infection 

? Whilst there is currently no approved treatment for maternal primary CMV, evidence is emerging 
regarding the use of high dose Valaciclovir to reduce secondary (vertical) infection4 (3, 4). 
Valaciclovir may be offered if amniocentesis for CMV PCR after 21 weeks gestation is positive, 
after MFM and paediatric infectious disease subspecialist consultation. The effectiveness of this 
treatment option is still under investigation 

? Some pregnant women with CMV may present with acute visceral disease (hepatitis, 
pneumonia, purpura and severe thrombocytopenia)10. Supportive management should be 
considered for these women, including increased oral hydration with intravenous support if 
required. 

Infection precautions 

? Staff precautions: - To help prevent CMV infections, employers and workers should treat all 
body fluids as if they are potentially infectious with CMV, using Standard Infection Control 
Precautions (including the use of gloves and regular hand washing)9. 

? After a risk assessment, maternity and/or neonatal units may initiate transmission based 
precautions if there are poor infection control practices in that unit. 

o This may include sub-optimal hand hygiene and adherence to standard precautions. 

o It may also be considered not to allocate pregnant staff to care for the suspected or 
confirmed CMV positive patient 

Maternal counselling 

? Women with suspected CMV infection should be considered for referral to a Maternal Fetal 
Medicine and Infectious Diseases service for counselling at the earliest opportunity9. 

? Aboriginal women should be referred to their nominated Aboriginal Health Professional or an 
Aboriginal healthcare worker at the earliest opportunity to support a culturally safe, appropriate 
and responsive care plan 

? All Aboriginal women and/or an appropriate family member should be consulted regarding any 
decisions in relation to their care, in the first instance.  

? Women with amniotic fluid (AF) positive samples by PCR or culture for CMV should be 
counselled of their options for non-treatment, treatment with uncertain effectiveness or they may 
consider termination of the pregnancy (depending on gestational age) 10. 

? Caution should be advised when interpreting findings as features associated with symptomatic 
congenital infection are not always predictive of the degree of fetal damage9. 

? The risk of severe adverse neonatal neurological outcome is highest after primary infection in 
the first half of pregnancy11. 

? Features of fetal infection in early pregnancy include:   

o Severe early onset fetal growth restriction   

o Microcephaly 

o Intracranial calcifications10. 



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? Features of fetal infection in late pregnancy include: 

o acute visceral disease (hepatitis, pneumonia, purpura and severe thrombocytopenia)11. 

? Mother to fetus: vertical transmission after maternal primary CMV increases with advancing 
gestation3. 

o Periconception period 21%  

o 1st trimester 37%  

o 2nd trimester 40%  

o 3rd trimester 66% 4.  

? Importantly, risk of fetal insult after primary infection decreases significantly after the first 
trimester1  

o Periconception 29%  

o First trimester 19%  

o 2nd trimester 1%  

o 3rd trimester &lt;1%4. 

? Therefore, the highest risk of fetal insult follows primary infection in the periconception period or 
first trimester, being in the order of approximately 6-7% (risk of transmission x risk of fetal 
insult)4.  

? If infected in the first trimester, the newborn will be symptomatic in approximately 9% of cases, 
with much lower rates of ?1% following periconception or 2nd/3rd trimester infection4. 

Fetal risk assessment 

? Fetal diagnosis is best achieved by a combination of fetal ultrasound, amniocentesis and + / - 
fetal serology. 

o Positive results do not predict any degree of fetal damage, a referral to a maternal fetal 
medicine specialist, and a specialist with expertise in perinatal infections is 
recommended9. 

Ultrasound  

? Consider serial fetal ultrasound to detect features associated with symptomatic congenital CMV 
infection (sensitivity around 30   50 %)12. 

? Features associated with symptomatic congenital infection: 
o Microcephaly 

o Fetal Ascites 

o Hydrops  

o Oligo or polyhydramnios 

o Hepatomegaly 

o Pseudomeconium ileus 

o Hydrocephalus (ventricular dilation) 

o Intrauterine growth restriction (IUGR) 

o Pleural or pericardial effusions 

o Intracranial calcification 

o Abdominal calcification4. 

Amniocentesis 

? Consider amniocentesis for polymerase chain reaction (PCR) and culture 
o Sensitivity is increased by waiting ? 6-8 weeks after infection at not less than 21 weeks 

gestation; with sensitivity 45% at &lt; 20 weeks gestation, and 80-100% if performed ? 21 
weeks gestation2. 

o Specificity approaches 100% 

o Positive results identify CMV-infected fetuses (PPV=100%) but cannot predict the degree 



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of fetal damage2. 

Low viral loads (&lt;10^3 copies/mL) are often associated with asymptomatic congenital 
infection, although a correlation between high viral loads and fetal/neonatal outcomes has 
not been demonstrated2. 

Congenital CMV management 

? The prevention of congenital CMV is based on interrupting the maternal-fetal transmission or 
preventing maternal infection during pregnancy6. The role of hyper-immune globulin (HIG) in 
acute infection is controversial20(5) 

Maternal primary CMV infection  

? The newborn will be symptomatic in 10% of cases, and carry a 90 % risk of sequelae including: 
o Mortality (rate 5-10%)3, 

o Neurological abnormalities (microcephaly (rate 35-50%), seizures (rate 10%), 
chorioretinitis (rate 10-20%), mental retardation (rate ?70%)3,  

o Hearing loss (rate 20-50%)3. 

Perinatal Grief and Loss - Aboriginal people experience very high levels of Grief and Loss in their 
communities.  Perinatal loss demands ceremonial acknowledgement. Please discuss with their 
nominated Aboriginal Health Professional or Aboriginal Liaison Officer 

Maternal non-primary CMV infection (reactivation or reinfection) 

? There is a ? 1 % risk of transmission of CMV to the newborn3, 

? Most newborns will have asymptomatic congenital CMV (? 99 %)3, 

? Of these, approximately 5 % will suffer sensory neural hearing loss and 2 % will suffer 
chorioretinitis3, 

? If hearing is preserved at one year of age, intellectual development is unlikely to be affected3. 

Management of the Newborn 

? Medical review at birth6, 

? Detailed physical examination3.  

? Aboriginal woman should be consulted on the care of the newborn baby in the first instance. 

Consult with the preferred aboriginal health professional if requested 

? Decisions regarding the care of a newborn may vary among Aboriginal cultural groups. The 

involvement of an Aboriginal health professional should be sought to ensure cultural sensitivity 

and practices are acknowledged in the care and management of the newborn  

Laboratory investigations  

? Should be done as soon as possible after birth and before 3 weeks of age to confirm congenital 
CMV: 

o CMV PCR of urine is the gold standard for congenital infection, 

o PCR testing of saliva should be confirmed with a PCR urine test3, 

o Blood for quantitative CMV should be collected if anti-viral therapy in indicated, 

o After 3 weeks of age, confirmation of fetal infection also requires evidence of CMV via a 
PCR on the Newborn Screening Test or immunofluorescence studies of placental tissue2. 

Investigations 

? Where laboratory investigations confirm CMV, the following investigations are recommended: 

o Ophthalmology examination3, 



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o Cranial ultrasound (hydrocephaly)3, 

o CT of brain is not indicated due to the risks associated with radiation exposure, balanced 
against the low likelihood of sequelae (signs of intracranial calcification, ventriculomegaly, 
cerebral atrophy)2,  

o For symptomatic infants, magnetic resonance imaging is the preferred imaging modality 
for CMV infection of the brain3. 

Follow up 

? Infectious Diseases consultation in regard to possible treatment with Ganciclovir / 
valganciclovir13. 

? Paediatric review of asymptomatic infants with congenital CMV, minimum of 1 visit at 12 
months, up to every 3 6 months for the first 2 years (include neurodevelopmental assessment) 

o The frequency of paediatric review of symptomatic infants with congenital CMV will 
depend on the extent of organ involvement5. 

o Routine AABR screening, with the addition of referral to paediatric audiology for long term 
review of possible late onset hearing loss5. 

All follow up plans should be referred to an Aboriginal health professional and/or Aboriginal 
Community Controlled health service where the family will receive follow up care. 

For further information, refer to Flowchart 4   Neonatal Diagnosis and Management 

Future Pregnancies 

? There are no consistent guidelines available in relation to the timing of a subsequent pregnancy, 
however most sources advise 6-12 months12. 

? Awaiting a decline in CMV IgM to an undetectable level with a concurrent increase in CMV IgG 
avidity to a high level is likely to represent a low risk of vertical CMV transmission in future 
pregnancies14,15. 

Supporting Documents 

This PPG must be used in conjunction with: 

? Standards for Maternity and Neonatal Services in SA 2021 Clinical Directive. Available at 
www.sahealth.sa.gov.au/perinatal and web-based App named Practice Guidelines available at 
https://extapps.health.sa.gov.au/PracticeGuidelines 

? SA Health Perinatal Practice Guidelines. www.sahealth.sa.gov.au/perinatal and web-based App 

named Practice Guidelines available at https://extapps.health.sa.gov.au/PracticeGuidelines 

 

Additional Resources 

 Prevent CMV during pregnancy  

Prevent CMV during pregnancy brochure (SA Health) 

 

 Reducing the risk of CMV during pregnancy  Pamphlet,  

an initiative of The Cerebral Palsy Alliance, CMV Australia and The Australian College of Midwives 

Reducing the risk of CMV in pregnancy (Cerebral Palsy Alliance)  

 

 

 









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References 

1 Chatzakis C, et al; Timing of primary maternal cytomegalovirus infection and rates of vertical transmission 
and fetal consequences, American Journal of Obstetrics &amp; Gynecology,  2020, 223(6): Pg 870- 883 311, 
www.ajog.org 

2 Beswick R, et al; Integration of congenital cytomegalovirus screening within a newborn hearing screening 
programme, Journal of Paediatrics and Child Health, February 2019, Pg 1381 1388 

3 Palasanthiran P,  et al; Management of Perinatal Infections 2014, Australasian Society for Infectious 
Diseases (ASID) Inc, Australia by TTR Print Management Pty Ltd; 
https://www.asid.net.au/documents/item/368 

4 Shahar-Nissan K et al; Valaciclovir to prevent vertical transmission of cytomegalovirus after maternal 
primary infection during pregnancy: a randomised, double-blind, placebo-controlled trial, The Lancet, Vol 
396, September 2020, Pg 779; www.thelancet.com 

5 Naing Z, et al: Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, 
diagnosis and prevention, Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016, Pg 
9-18 

6 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists; Prevention of 
congenital cytomegalovirus (CMV) infection, C-Obs 64, March 2019 

7 James S, Kimberlin D; Advances in the Prevention and Treatment of Congenital Cytomegalovirus 
Infection, Curr Opin Pediatr. Author manuscript, February 2017. 

8 SA Health Perinatal Practice Guidelines. www.sahealth.sa.gov.au/perinatal and web-based App named 
Practice Guidelines available at https://extapps.health.sa.gov.au/PracticeGuidelines 

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2011; Pg 342.e1-6, www.ajog.org 

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1377-1384, www.cvi.asm.org 

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cmv/pregnancies-after-cmv/ 

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and improved with education, The Royal Australian and New Zealand College of Obstetricians and 
Gynaecologists, 2019, Pg 1-7, www.ranzcog.com.au 

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infection during pregnancy. Clin Vaccine Immunol. 2014;21(10):1377-84. 

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pregnancy to prevent congenital infection: a cost-effectiveness perspective. BJOG : an international 
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Vox Sanguinis, The International Journal of Transfusion Medicine, vol109, pp. 11-17 
















South Australian Perinatal Practice Guideline 

 Cytomegalovirus  
 

 

 
INFORMAL COPY WHEN PRINTED  Page 16 of 17 

OFFICIAL 
 

 

Acknowledgements 

The South Australian Perinatal Practice Guidelines gratefully acknowledge the contribution of 
clinicians and other stakeholders who participated throughout the guideline development process 
particularly:  

Write Group Members 

Linda Campbell 
Lisa Catt 
Dr Penny Charlton 
Vanessa Drummond 
Bonnie Fisher (EO) 
Dr Kate Gowling 
Kathryn Hansen 
Wendy Hermel 
Mary Mills 
Dr Charlotte Paull 
Genevieve Schmidt 
Catherine Smythe 
Dr Brett Ritchie 
A/Prof Chris Wilkinson 

SAPPG Management Group Members 

Sonia Angus 
Lyn Bastian 
Dr Elizabeth Beare 
Elizabeth Bennett 
Dr Feisal Chenia 
John Coomblas 
Dr Danielle Crosby 
Dr Vanessa Ellison 
Dr Ray Farley 
Jackie Kitschke 
Dr Kritesh Kumar 
Catherine Leggett 
Dr Anupam Parange 
Rebecca Smith 
A/Prof Chris Wilkinson 

  



South Australian Perinatal Practice Guideline 

 Cytomegalovirus  
 

 

 
INFORMAL COPY WHEN PRINTED  Page 17 of 17 

OFFICIAL 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Ownership &amp; History 

 

Developed by: SA Maternal, Neonatal &amp; Gynaecology Community of Practice 
Contact: HealthCYWHSPerinatalProtocol@sa.gov.au 
Endorsed by: Domain Custodian, Executive Director 
 Commissioning and Performance 
 Department for Health and Wellbeing, SA 
Next review due:  10/03/2027 
ISBN number:   978-1-76083-488-3 

PDS reference:  CG169 (PPG011) 
Policy history: Is this a new policy?  N 
 Does this policy amend or update and existing policy? Y 
 If so, which version? V4.1 
 Does this policy replace another policy with a different title?  N 
 

Approval 
Date 

Version Who approved New/Revised Version Reason for Change 

10 March 
2022 

V5 Domain Custodian 
Executive Director 
Commissioning and Performance 
Department for Health and Wellbeing, SA 

Reviewed to align with revised 
national guidelines 

5 July 
2018 

V4.1 SA Health Safety and Quality Strategic 
Governance Committee 

Review date extended to 5 
years following risk 
assessment. New template. 

19 Dec 
2014  

V4 SA Health Safety and Quality Strategic 
Governance Committee 

Reviewed  

08 Jan 
2013  

V3 SA Health Safety and Quality Strategic 
Governance Committee  

Reviewed in line with 
scheduled review date 

05 May 
2009  

V2 Maternal and Neonatal Clinical Network Reviewed in line with 
scheduled review date 

08 Apr 
2004  

V1 Maternal and Neonatal Clinical Network Original approved version. 

 
 



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