42 MONDAY. SEPTEMBER *

Study Methods: CMV IgM antibody in cord serum was measured with IgM antibody capture ELISA. The sera were collected from 3314 infants born in our hospital from 1994 to 1998. Results: 8 of 3314 infants had CMV IgM antibody or intrauterine transmission of CMV. The total IgM antibody was more than 20 mg/dl in five sera. 6 of 8 mothers were multipara and 3 had seroconversion. 3 pregnancies resulted in premature birth; 2 were due to PROM and the other hydrops fetalis with atresia ani and hypoplastic left ventricle. The case with hydrops died one day after delivery. 1 of the premature infants developed spastic quadriplegia. Conclusions: In Japan 0.24% of infants were found congenitally infected with CMV and some of them developed handicaps. Multiparity and seroconversion were the risk factors. Although rare, CMV infection must be carefully examined during pregnancy and after birth.

FC1.15.04 VERTICAL TRANSMISSION OF HUMAN PAPILLOMAVLRUS; PRELIMINARY RESULTS OF TURKU-RESEARCH M. Rintala ‘1, S. Grenman’), U. Ekblad’), E. Isolauri’), P. Kero’), M. Puranen“), P. P6118nen’)3) and S. SyrjPnen“) 1) Dept. OB/GYN and 2) Dept. of Pediatrics, Turku University Central Hospital, 3) Inst. of Biomedicine and 4) Inst. of Dentistry and MediCity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland

Objectives: The purpose of the 3-year long follow-up study is to evaluate transmission of human papillomavirus (HPV) infection from parents to neonates. Study methods: At the moment the study population consists of 150 families; 18-27 year old mothers, fathers (42%) and neonates delivered at Turku University Central Hospital. HPV DNA was studied by cervical and oral swab samples from pregnant woman and by oral swab and semen samples from father. HPV DNA of neonate was tested by oral and genital swab samples immediately and three days after the birth. Follow-up is at 1,2,6, 12, 24 and 36 months after the birth. HPV DNA is detected by nested PCR (MYO9/11 and GPOS+/GP06+) targeting the Ll region of the HPV genome. The specifity of PCR was confirmed by nonradioactive Southern blot hybridizations. Results: Of the mothers 20.3% (16179) of cervical and 15.4% (161104) of oral samples were HPV DNA positive, of which high risk HPV types were identified in 15.2% (12179) and 12.7% (7/55), respectively. Two months after the delivery 19.3% (11157) of cervical samples were still HPV DNA positive. In neonates just after delivery 17.2% (11164) of genital and 34.9% (22163) of oral samples were HPV DNA positive; high risk types were 14.1% and 28.6%, respectively. One month after the delivery still 9.5% (8184) of genital and 12.0% (9175) of oral samples were HPV DNA positive. Two out of 12 (16.7%) fathers had an HPV DNA positive semen sample by PCR. Conclusions: The detection rate of HPV DNA in pregnant woman was similar to that repated earlier (20%). Newborns of these mothers had high detection rate of HPV DNA both in oral and genital regions. HPV was not only a transient passager, but causes a true infection, while 12% of the children at the age of one month still have HPV DNA.

FCl.lS.05 CYTOMEGALOVIRUS,TOXOPLASMA AND PARVOVLRUS IN SINGAPOREAN PREGNANT WOMEN A Wang, KH Tan, CS Tee, GSH Yeo Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, 100 B&t Timah Road, Singapore 229899

Objectives: The aim of our study was to determine the seroprevalence of Cytomegalovirus (CMV), Toxoplasma and Parvovirus in our local antenatal population. Study methods: 120 consecutive antenatal women seen in a private clinic in KK Women’s and Children’s Hospital between the period of October 1997 and March 1998 were included. Blood was taken for CMV IgG, Toxoplasma IgG and Parvovirus B19 IgG and IgM. Results: The mean age was 29.2 years, the mean gestation was 19.0 weeks and the mean parity was 1.0. 81.7% of the patients were Chinese, 1.7% were Indians, 3.3% were Malay and 3.3% comprised other races. A total of 87% of the patients were seropositive for CMV IgG, 17.2% were positive for Toxoplasma IgG and 30% were seropositive for Parvovirus IgG.

There was a trend of increasing seropositivity with age in all three groups, however only Parvovirus B19 reached statistical significance. The incidence of all the three infections were higher among the Malays, Indians and other races compared to the Chinese. Conclusion: CMV is the commonest congenital infection in pregnancy, and it is endemic in Singapore. Seropositivity does not protect against re-infection or fetal infection. Toxoplasmosis seropositivity is low in our population compared to neighbouring Asian countries. Screening for Parvovirus may be important in cases of non-immune hydrops, as it is not uncommon. Prevention of congenital CMV, Toxoplasmosis and Parvovirus infection is mainly by educating the antenatal population.

FCl.lS.06 CYTOMEGALOVIRUS INFECTION AND PREGNANCY N. Merabishvili (l), T. Tsertsvadze (2),(l) Faculty of OBIGYN, Tbilisi State Medical University, Georgia, Russia, (2) Tbilisi Center of AIDS and Clinical Immunology, Georgia, Russia

Objectives: The aim of this study was to investigate the incidence of cytomegalovirus (CMV) infection in pregnant women and the outcome of pregnancy in cases of the above infection. Materials and Methods: The cohort under study was divided into 2 groups: the first group consisted of 45 women with physiological anamnesis, the second group consisted of women with aggravated obstetrical anamnesis (spontaneous abortion, premature labor, stillbirth). The blood serum, anti-CMV IgM, IgG class and IgG avide antibodies were detected using the method of immonoenzime analysis. Results: In the first group, the IgG antibodies were detected in 26 pregnant women (57.7%), 6 women had IgM antibodies. Among those latter 3 were detected low-avide IgG antibodies (primary active infection), 3 had high-avide IgG antibodies (the reactivation of the latent infection). The premature labor was observed in 8 cases, of those 4 had IgM antibodies. The percent of premature labor in cases of active infection was rather high (66.77) D compared to the pregnant women who did not have IgM antibodies (10.3%). In the second group, the IgG antibodies were found in 34 women (65.4%), 8 had IfM antibodies (15.4%), of those 3 had the primary active infection while 5 had reactivation of the latent infection. Premature labor was observed in 12 cases. Of those, in 4 cases was detected IgM antibodies. In 1 of the latter 4 cases, the patient had a primary active infection, 3 - reactivation of the latent infection. In cases of active infection, the percent of premature labor was rather high - 50%

compared to the IgM seronegative pregnant women. Conclusion: The prevalence of the CMV was rather high in both groups of the pregnant women under study being somewhat higher in women with aggravated obstetrical anamnesis: 57.7% and 65.4% respectively. The analysis of the results demonstrated that in cases of active infection (both primary active infection and reactivation of latent infection) the percent of premature labor was higher compared to the sero-negative pregnant women.

FCl.lS.07 MORPHOLOGICAL ASPECTS IN CLINICAL DIAGNOSTIC OF PLACENTAL INSUFFICIENCY IN PREGNANT WITH HERPES VIRUS INFECTION Tioutiounnick V.L. Research Centre of Obstetrics, Gynecology & Perinatology, Moscow, Russia

Objectives: The necessity to study herpes virus infection (HSV, CMV) is mandated by a countinuing increase of the number of patients affected by that disorder, high rate of perinatal losses and by birth of babies with severe brain damage. Methods: The analysis of the pathomorphological researches of the 177 samples of women with herpes virus infection in comparison with the peculiarities of pregnancy, functional status of fetal placental complex and the condition of newborns and neonates was performed. Results: We obtained following results: the herpes virus infection leads to decrease of fetal and maternal blood flow in 17.6%, intrauterine growth retardation in 21.7%, intrauterine hypoxia in 29.6%. It was found out, that this infection leads to significant changes in afterbirth, such as lymphoplasmacytic infiltration, vascular damage and sclerosis. The character of changes directly depends on frequency, duratation and periods of the disease relapses.