Introduction: Early pregnancy of this 31-year-old 3G/3P mother was uneventful. At 22 weeks of gestation, reduced amniotic fluid, hyperechogenic bowel and scaphocephaly were seen on antenatal ultrasound. The mother was referred to the fetal medicine unit at our hospital for further evaluation. Amniocentesis revealed a normal female karyotype. Maternal TORCH screening showed primary cytomegalovirus (CMV) infection with positive IgG and IgM titers, and a viral load of 1.2 million DNA copies per ml. Amniotic fluid testing confirmed fetal infection with positive culture, antigen testing and polymerase chain reaction (PCR).