TABLE 1.

Methods for diagnosing cCMV

Method	Use	Limitations	cCMV transmission [reference(s)]
			PPV (%)	NPV (%)
Maternal serologya,b
Anti-CMV IgM	Diagnosis of maternal CMV infection	Aspecific and crossreactive results described; CMV IgM may persist long after (re-)infection	9.8–28.5 [51]	100.0 [51]
Seroconversion	Diagnosis of maternal CMV infection	Baseline and follow-up samples are required	25.0 [51]	100.0 [51]
Anti-CMV IgG avidity	Discrimination between primary and nonprimary maternal CMV infection	Less informative after >18 week of gestation, cutoff thresholds vary among different assays	18.8–26.3 [52]	90.9–100.0 [52]
CMV DNA in maternal blooda,b	Diagnosis of active maternal CMV infection	Decreasing sensitivity after the first month postinfection	56.3 [53]	64.7 [53]
Amniocentesisb
CMV culture	cCMV diagnosis	High turnaround time	100.0 [6, 50]	84.6–92.6 [6, 50]
CMV DNA	cCMV diagnosis	False-positive results described	93.8–100.0 [6, 50]	92.7–93.1 [6, 50]
Cordocentesisc
CMV culture	cCMV diagnosis	High turnaround time	100.0 [6]	64.6 [6]
CMV DNA	cCMV diagnosis	None described	100.0 [6, 50]	84.4–94.4 [6, 50]
Anti-CMV IgM	cCMV diagnosis	Low sensitivity; only ≥20 weeks of gestation	100.0 [6, 50]	70.6–88.0 [6, 50]
Imaging examinations
Ultrasound	Predict cCMV outcome and severity	Sensitivity dependent on the timing of examination; not specific for CMV; complex interpretation requiring highly specialized medical personnel/neuroradiology consulting	22.2–70.6d [42, 54]	88.3–95.7d [42, 54]
Magnetic resonance imaging	Predict cCMV outcome and severity	Sensitivity dependent on the timing of examination; not specific for CMV; complex interpretation requiring highly specialized medical personnel/neuroradiology consulting	19.2–66.7d [42, 54]	79.5–100.0d [42, 54]

^aLimited correlations with cCMV.

^bNot associated with cCMV severity.

^cHigher risk of fetal damage/loss compared to amniocentesis.

^dPercentages for symptomatic cCMV in newborns.