RT Journal Article SR Electronic T1 Congenital cytomegalovirus infection in twin pregnancy JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e242712 DO 10.1136/bcr-2021-242712 VO 14 IS 7 A1 Ana Araújo Carvalho A1 Cláudia B Silva A1 Maria Luísa Martins A1 Gonçalo Cassiano Santos YR 2021 UL http://casereports.bmj.com/content/14/7/e242712.abstract AB Cytomegalovirus (CMV) infection is one of the preeminent congenital viral infections, and despite its potential morbidity, uncertainty about its physiopathology, prevention and treatment remains until now. We report a case of a dichorionic and diamniotic twin pregnancy in which only one of the fetus had signs of being affected. The first twin had prenatal diagnosis of intrauterine growth restriction and hyperechogenic bowel, attributable to CMV infection, while there was no evidence of infection of the second one. Prenatal treatment was done with maternal administration of valacyclovir and postnatal treatment of the infected newborn with oral valganciclovir with normal neurodevelopment assessment at 12 months corrected age. In this case, maternal CMV infection was not equally transmitted to both fetuses, suggesting that there may be intrinsic fetal and placental factors influencing both transmission and the clinical features of the infection.