De Santis M, Cavaliere A F, Straface G, Caruso A
Telefono Rosso, Teratology Information Service, Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Largo A. Gemelli, 8. Rome, Italy.
Reprod Toxicol. 2006 May;21(4):390-8. doi: 10.1016/j.reprotox.2005.01.014.
Rubella is the first virus demonstrated as a teratogen. There is a high risk to develop congenital rubella syndrome (CRS) if the infection occurs in the first part of pregnancy, particularly in women without specific immunological protection. Specific therapies to prevent CRS are not available. Many developed countries have specific vaccination programs and maternal rubella is rare. However, in developing countries or where campaigns of rubella surveillance and preconceptional vaccination are inadequate, there are still cases of CRS registered despite primary possibilities of prevention. Maternal infection is not indicative of vertical transmission in 100% of cases, and damage does not necessarily occur in all cases of fetal infection. This is the reason why an adequate prenatal counselling is mandatory, particularly in cases of proven maternal infection. Advanced prenatal diagnostic techniques, invasive or not, should be offered to the women especially in order to distinguish the cases without fetal damage. Prevention of voluntary interruption of pregnancy for the latter or in case of maternal false IgM rubella antibody positivity or IgM "chronic carrier" patients is mandatory. World wide, the aim is to perform an adequate primary prevention through vaccination of childbearing age women without specific immunological protection.
风疹是第一种被证实为致畸原的病毒。如果在妊娠早期发生感染，尤其是在没有特异性免疫保护的女性中，发生先天性风疹综合征（CRS）的风险很高。目前尚无预防CRS的特异性疗法。许多发达国家都有特定的疫苗接种计划，孕妇风疹很少见。然而，在发展中国家或风疹监测和孕前疫苗接种活动不足的地区，尽管有初步的预防可能性，但仍有CRS病例登记。母亲感染并非在所有病例中都意味着垂直传播，而且并非所有胎儿感染病例都会出现损害。这就是为什么必须进行充分的产前咨询，尤其是在确诊母亲感染的情况下。应向女性提供先进的产前诊断技术，无论是否具有侵入性，特别是为了区分没有胎儿损害的病例。对于后者，或者在母亲风疹IgM抗体假阳性或IgM“慢性携带者”患者的情况下，必须防止自愿终止妊娠。在全球范围内，目标是通过为没有特异性免疫保护的育龄妇女接种疫苗来进行充分的一级预防。
