The value of ELISA, N-PCR and RT-PCR in clinical practice for pregnant women with HCMV infection was investigated. 5581 pregnant women were screened by ELISA. Among them, 100 cases were positive for IgM (group 1), 69 for both IgM and serous DNA (group 2) and 69 for both IgM and mRNA (group 3). The infectious status, maternal-fetal transmission and pregnancy outcome were monitored. It was demonstrated that the accordance rate of group 3 and group 2 with group 1 was 56.25% and 43.75%, respectively. The maternal-fetal transmission rate in the group 1, 2 and 3 was 19.00%, 40.58% and 46.15%, respectively, with a significant difference found between group 2, 3 and group 1 (P < 0.01). Incidence of spontaneous abortion, fetal death, fetal abnormality and neonatal death in group 1, 2 and 3 was 10.00%, 15.94% and 30.77%, respectively, and that of group 3, 2 was 4 and 2 times as much as that of group 1, respectively (OR = 4.00, P < 0.001; OR = 2.343, P < 005, respectively). It was concluded that HCMV-IgM(+) can only be considered as an screening indicator for pregnant women with HCMV infection, while IgM(+) combined with serous DNA(+) or mRNA(+) indicates active infection and has a high incidence of maternal-fetal transmission and abnormal pregnancy outcome.