{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:15:47Z","timestamp":1775466947903,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify the transplacental transfer of aciclovir at an amount equivalent to 2\u2009g of valaciclovir corresponding to the fractionated dosing regimen given four times daily used to reduce congenital cytomegalovirus (CMV) transmission and to treat the CMV\u2010infected fetus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Experimental ex\u00a0vivo study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Dual closed\u2010loop perfusion of isolated human placental cotyledons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Placentas collected at term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Placental transfer was assessed using the dual closed\u2010loop ex\u00a0vivo perfusion. Aciclovir was perfused in the maternal compartment at a concentration corresponding to the oral dose of 2\u2009g of valaciclovir taken every 6\u2009h (8\u2009g\/day). Samples from maternal and fetal compartments were collected at regular intervals over a 3\u2010h period. Aciclovir concentrations were measured using chromatographic techniques. The transfer rate was calculated as the ratio of the number of moles of fetal aciclovir to the number of fetal and maternal moles at 3\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine perfusion experiments met the criteria for success and could be used for interpretation. The mean transplacental transfer rate of aciclovir was 17.4% (SD: 7.8%). With a single 2 g dose, fetal exposure to aciclovir remained below the IC50 for CMV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The transplacental transfer of aciclovir is low. Despite aciclovir's low molecular weight and hydrophilicity, moderate plasma protein binding and rapid renal elimination may limit placental availability, and the observed transfer was lower than expected for passive diffusion, suggesting involvement of facilitated uptake or efflux mechanisms. These results support the current rationale for high\u2010dose valaciclovir regimens in pregnancy and suggest a potential role for transporter\u2010mediated drug transfer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70168","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:55:16Z","timestamp":1769993716000},"page":"1241-1248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Congenital\n                    <scp>CMV<\/scp>\n                    Infection: Determination of Transplacental Passage of Aciclovir by Ex\u00a0Vivo Placental Perfusion"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3185-7194","authenticated-orcid":false,"given":"Helyett","family":"Ollivier","sequence":"first","affiliation":[{"name":"Fetal Medicine and Obstetric Department, APHP Necker\u2010Enfants Malades Hospital  Paris 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