Maternal-Fetal Medicine Department, Institut Clínic de Ginecologia, Obstetrícia I Neonatologia, University of Barcelona, Barcelona, Spain.
Fetal Diagn Ther. 2010;28(1):1-8. doi: 10.1159/000309155. Epub 2010 Jun 19.
The risk of transmission of human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C virus (HCV) during invasive procedures may not be negligible, although it has been poorly assessed. The risk of hepatitis B transmission during amniocentesis seems to be low, but it may be increased in women with a positive HBeAg. HCV transmission risk cannot be established because evidence is lacking. No information exists about other invasive procedures in such infections. An increased risk of vertical transmission following an invasive procedure was suggested in HIV infection, but amniocentesis seems to be safe when performed under highly active antiretroviral treatment, with a low viral load and when avoiding placental passage. International guidelines do not clearly define policies to screen for maternal blood-borne virus infection during invasive procedures. Nevertheless, serological status should be assessed in all cases and parents should be aware of the existing evidence for transmission risk. Transplacental amniocentesis should always be avoided.
在有创性操作过程中，人免疫缺陷病毒（HIV）、乙型肝炎（HBV）和丙型肝炎（HCV）的传播风险可能不可忽视，尽管这一点尚未得到充分评估。羊膜穿刺术过程中乙型肝炎的传播风险似乎较低，但 HBeAg 阳性的女性可能会增加。由于缺乏证据，无法确定丙型肝炎的传播风险。在这些感染中，没有关于其他有创性操作的信息。在 HIV 感染中，有研究提示有创性操作后垂直传播的风险增加，但在高活性抗逆转录病毒治疗下、病毒载量低且避免胎盘传播时，羊膜穿刺术似乎是安全的。国际指南并未明确规定在有创性操作期间筛查母体血液传播病毒感染的策略。然而，所有情况下都应评估血清学状态，并且应让父母了解关于传播风险的现有证据。应始终避免经胎盘羊膜穿刺术。
