Serological and Molecular Diagnosis of Rubella virus and Cytomegalovirus in aborted Patients in Al-Najaf province

Abstract

Background: Viral infections such as Rubella and Cytomegalovirus are feared risk during pregnancy. Rubella and Cytomegalovirus virus are fairly the respective major diagnostic issues in pregnancy, the laboratory diagnosis, and its rational use in combination with clinical information are presented, also the value of passive prophylaxis, therapy, and prenatal diagnosis as well as the possible management for diminishing the infection problems in pregnancy.

Aims of study: The study was aimed to evaluate the ELISA result for rubella and cytomegalovirus (CMV) IgM and IgG and compare the results of the ELISA with RT-PCR to arbitrate discordant results.

Methodology: The present study was carried out on 57 pregnant women, all of them had bad obstetric history (BOH). Patients were between 15-40 years old, and they were attending Al- Zahra Teaching Hospital during the period of May 2012 till May 2013. Serological evaluation for Rubella Cytomegalovirus infections were carried out by using IgM and IgG Enzyme Linked Immunosorbent Assay (ELISA ) method and molecular technique (Real Time - PCR).

Results :The results showed 12 patients (21.1%) were Seropositive for Rubella virus IgM, and 46 ( 80.7%) were Seropositive for Rubella virus IgG, while only 24 (42.1%) were Seropositive for both IgG and IgM at same time. In this study 2 patients ( 7.69 %) were Seropositive for both Rubella IgM and Cytomegalovirus together and 12 ( 30 %) were Seropositive for both Rubella IgG and Cytomegalovirus IgG. Regarding to Rubella infection ,the results showed that 12 (21.1%) were seropositive for Rubella IgM and 26 (45.6 %) were seropositive for Rubella IgG , while only 6 (17.5%) were seropositive for both IgM and IgG. The Real Time PCR results showed only 6( 10.5% ) were positive for Rubella virus and 3 (5.26 %) were positive for Cytomegalovirus .

Conclusion: The accurate diagnosis of Rubella and Cytomegalovirus infection should be done by molecular method and not based on ELISA test which should be used as screening test .

Recommendations :Advice the gynecologist to take care before give management for pregnant women that
present with more than one infection at same time unless confirm the diagnosis by more than one technique like
RT-PCR .