Cytomegalovirus in pregnancy: prevention, maternal screening, and the role of antivirals.

Cytomegalovirus (CMV) is the most common congenital infection in Australia and a leading cause of preventable childhood disability. Current Australian guidelines recommend targeted antenatal screening of women at higher risk for CMV infection. Serology testing should also be considered in women with clinical symptoms suggestive of CMV. Women with suspected CMV infection in pregnancy should be promptly referred to a maternal-fetal medicine or infectious diseases specialist. High-dose valaciclovir can reduce in utero transmission to the fetus following first-trimester maternal primary infection; however, long-term safety data are limited. Valaciclovir should only be prescribed by clinicians with specific expertise in CMV, such as maternal-fetal medicine or infectious diseases specialists. Universal hygiene counselling, targeted screening, careful timing of conception after infection, and structured psychological support are essential components of care.