Signore C
, Falls Church, Virginia, USA
Prim Care Update Ob Gyns. 2001 Jul;8(4):138-140. doi: 10.1016/s1068-607x(01)00073-7.
Rubeola, more commonly known as the "red measles" or "10-day measles," is a highly contagious exanthematous viral illness. Although most cases end with full recovery, rare but serious, even fatal sequelae such as encephalitis and pneumonia can occur. The incidence of measles worldwide has decreased dramatically since the introduction of effective vaccines. Nevertheless, outbreaks still occur among clusters of individuals, especially young adults, that vaccination programs have failed to reach. Susceptible young women are at unique risk because measles in pregnancy follows a more complicated course than in nonpregnant adults. Furthermore, pregnancies complicated by rubeola are more likely to end with spontaneous abortion or preterm delivery. In the United States, the currently used rubeola vaccine employs live-attenuated virus and is contraindicated in pregnancy. Nonpregnant women receiving rubeola vaccination should be advised to use effective contraception for 3 months after inoculation. These warnings persist despite the fact that an adverse pregnancy outcome after maternal measles vaccination has not been reported. Obstetrician/gynecologists must be familiar with rubeola and the management of pregnancies complicated by exposure to the disease. Furthermore, practitioners must actively seek and vaccinate susceptible individuals to minimize this ongoing threat to public health.
麻疹,更为人熟知的名称是“红色麻疹”或“十日麻疹”,是一种具有高度传染性的发疹性病毒性疾病。虽然大多数病例最终可完全康复,但可能会出现罕见但严重甚至致命的后遗症,如脑炎和肺炎。自有效疫苗问世以来,全球麻疹发病率已大幅下降。然而,在疫苗接种计划未能覆盖的人群中,尤其是年轻成年人中,仍会出现疫情爆发。易感年轻女性面临独特风险,因为孕期感染麻疹的病程比非孕期成年人更为复杂。此外,并发麻疹的妊娠更有可能以自然流产或早产告终。在美国,目前使用的麻疹疫苗采用减毒活病毒,孕期禁用。应建议接种麻疹疫苗的非孕期女性在接种后3个月采取有效的避孕措施。尽管尚未有关于孕妇接种麻疹疫苗后出现不良妊娠结局的报道,但这些警告仍然存在。妇产科医生必须熟悉麻疹以及对暴露于该疾病的妊娠的管理。此外,从业者必须积极寻找易感人群并为其接种疫苗,以尽量减少这种对公众健康持续存在的威胁。