Müllegger R R, Glatz M
Abteilung für Dermatologie, Landesklinikum Wiener Neustadt, Corvinusring 3-5, 2700, Wiener Neustadt, Österreich.
Hautarzt. 2010 Dec;61(12):1034-9. doi: 10.1007/s00105-010-2066-9.
The article outlines examples of a viral (varicella-zoster virus, VZV), a bacterial (Lyme borreliosis) and a parasitic (scabies) infection in pregnancy with their risk for the mother and/or child as well as their management. VZV infections cause various clinical scenarios depending on the maternal immune status and the time of infection. Herpes zoster usually poses no risk to the pregnant woman and there is no need for antiviral therapy. VZV infection of a seronegative mother, however, may lead to severe varicella in the pregnant woman and to congenital malformations (congenital varicella syndrome) in case of early infection or neonatal varicella in case of perinatal infection. Prompt therapy with acyclovir or administration of VZV immunoglobulin for prophylaxis is mandatory in those patients. In case of Lyme borreliosis of the mother, adequate antibiotic therapy with amoxicillin prevents harm to the fetus. Doxycycline is contraindicated during pregnancy. Scabies represents an important differential diagnosis of pruritic dermatoses in pregnancy and should be treated with permethrin 5% cream.
本文概述了孕期病毒感染（水痘-带状疱疹病毒，VZV）、细菌感染（莱姆病）和寄生虫感染（疥疮）的实例，以及它们对母亲和/或孩子的风险及治疗方法。VZV感染根据母亲的免疫状态和感染时间会导致不同的临床情况。带状疱疹通常对孕妇没有风险，无需抗病毒治疗。然而，血清学阴性的母亲感染VZV，可能会导致孕妇患严重水痘，在早期感染时会导致先天性畸形（先天性水痘综合征），围产期感染则会导致新生儿水痘。这些患者必须立即用阿昔洛韦治疗或给予VZV免疫球蛋白进行预防。如果母亲患有莱姆病，用阿莫西林进行充分的抗生素治疗可防止对胎儿造成伤害。孕期禁用多西环素。疥疮是孕期瘙痒性皮肤病的重要鉴别诊断疾病，应使用5%的氯菊酯乳膏进行治疗。
