Could CMV have caused incompatible with life twice?

[Mustbeareason]

Hi, I've had 2 terminations due to medical reasons (Holoprosencephaly & Ventriculomegaly) both from 12 week scan. I've just had my genetic test results and they've come back normal. But my bloods showed I have CMV which is a potential cause. The consultant has asked for previous blood tests to be checked & to see if I had active CMV during pregnancy but the results will take a month to come back. My question is is it possible to have had active CMV during my 12 week pregnancy ending in oct 2016 & also in my 13 week pregnancy ending in august 2017? I thought CMV is usually only active for up to 6 months which would mean this couldn't explain both. Thanks in advance.

Hi, active CMV infections have a small/moderate risk of causing birth defects in developing fetuses however there is big difference between latent and active CMV infections a bit like chicken pox/shingles. When you are exposed to CMV you initially have an active infection and most people don't even realise they have it as the symptoms are usually pretty vague/mild/non specific (might get diagnosed as a cold instead, so on). Then it becomes latent meaning that the virus is not actively making you sick but it's just chilling around because your body can't completely get rid of it. Rarely a latent infection can become active again if a person becomes immunocompromised, CMV is very important in transplant situations particularly bone marrow as it can cause transplant rejection.

Having said that, majority of adults have latent CMV, it's unusual not to have it - I haven't got it yet and I always get asked to donate blood for premie babies because I don't have it. Pregnancy while having latent CMV is very common and usually absolutely fine, it only becomes an issue if the mum doesn't have latent CMV and gets active CMV during pregnancy or if she has latent and becomes immunocompromised so she gets active CMV.

CMV usually doesn't stay active for more than a few weeks or months so it would be unusual for it to have affected both of your pregnancies unless you were very unlucky to relapse from latent to active again during the second pregnancy, but it could happen. There isn't really a way to know for sure though unless the hospital tested for it while you were pregnant (it is too late to do it retroactively now) which I guess is what your doctor is trying to find out now?

Good luck.