Background/Objectives: CMV (cytomegalovirus) is associated with several developmental
disorders. The incidence of congenital cytomegalovirus infection is around 1%, depending
on the region. Previous prospective studies have shown that certain ultrasound findings
are predictive factors for prenatal CMV infection. Methods: During this systematic
review, we searched PubMed and Embas. Out of 569 results, 19 met our search criteria
(we included cases where prenatally positive amniocentesis PCR for CMV was performed
or autopsy confirmed the CMV diagnosis). A total of 237 cases were reported from 19
studies. Results: In 64 cases, abortion or perinatal death occurred. The most common
prenatal abnormalities were small for gestational age (n = 47), ventriculomegaly (n
= 51), and hyperechogenic bowels (n = 39). A subependymal cyst was the most common
prenatal MRI abnormality (n = 20). Hearing loss was observed in 61 cases (42 mild,
19 severe). Among prenatal signs, we found a correlation between hearing loss and
ventriculomegaly (Fisher's exact test, p = 0.0052). The most common neurological complication
was speech delay. We were able to demonstrate a prenatal association with neurological
complications and subependymal cyst (Fisher's exact test, p = 0.00003547), but this
pattern could only be reliably seen with MRI. Conclusions: In prenatally diagnosed
CMV infection, ultrasound signals may be suitable for estimating the outcome. Conducting
a prospective study and establishing a score would be worthwhile for its clinical
application. In cases of ultrasound abnormalities and suspicion of CMV, it is worth
performing a prenatal MRI, even in everyday practice.
