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孕期细小病毒B19感染

Parvovirus B19 infection in pregnancy.

作者信息

de Jong Eveline P, de Haan Timo R, Kroes Aloys C M, Beersma Matthias F C, Oepkes Dick, Walther Frans J

机构信息

Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

J Clin Virol. 2006 May;36(1):1-7. doi: 10.1016/j.jcv.2006.01.004. Epub 2006 Feb 20.

Abstract

Parvovirus B19 is a small single-stranded DNA virus and a potent inhibitor of erythropoiesis, due to its cytotoxicity to erythroid progenitor cells. Infection with parvovirus B19 during pregnancy can cause several serious complications in the fetus, such as fetal anemia, neurological anomalies, hydrops fetalis, and fetal death. Early diagnosis and treatment of intrauterine parvovirus B19 infection is essential in preventing these fetal complications. Testing maternal serum for IgM antibodies against parvovirus B19 and DNA detection by PCR can confirm maternal infection. If maternal infection has occurred, ultrasound investigation of the fetus and measurement of the peak systolic flow velocity of the middle cerebral artery are sensitive non-invasive procedures to diagnose fetal anemia and hydrops. Intrauterine transfusion is currently the only effective treatment to alleviate fetal anemia, but if the fetus is (near) term, induction of delivery should be considered. Most maternal infections with parvovirus B19 occur through contact with infected children at home. Individual counseling of susceptible pregnant women will reduce unnecessary fetal deaths.

摘要

细小病毒B19是一种小型单链DNA病毒,由于其对红系祖细胞具有细胞毒性,因此是红细胞生成的强效抑制剂。孕期感染细小病毒B19可导致胎儿出现多种严重并发症,如胎儿贫血、神经异常、胎儿水肿和胎儿死亡。早期诊断和治疗宫内细小病毒B19感染对于预防这些胎儿并发症至关重要。检测孕妇血清中抗细小病毒B19的IgM抗体以及通过聚合酶链反应(PCR)进行DNA检测可确诊孕妇感染。如果孕妇已发生感染,对胎儿进行超声检查并测量大脑中动脉的收缩期峰值流速是诊断胎儿贫血和水肿的敏感无创方法。宫内输血目前是缓解胎儿贫血的唯一有效治疗方法,但如果胎儿已(接近)足月,则应考虑引产。大多数孕妇感染细小病毒B19是通过在家中与受感染儿童接触所致。对易感孕妇进行个体化咨询将减少不必要的胎儿死亡。

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