10例产前诊断为细小病毒B19感染及胎儿水肿的胎儿的临床特征
Clinical features of 10 fetuses with prenatally diagnosed parvovirus b19 infection and fetal hydrops.
作者信息
Kyeong Kyu-Sang, Won Hye-Sung, Lee Mi-Young, Shim Jae-Yoon, Lee Pil Ryang, Kim Ahm
机构信息
1Department of Obstetrics and Gynecology, Chungbuk National University, Cheongju, Korea.
出版信息
Fetal Pediatr Pathol. 2015 Feb;34(1):49-56. doi: 10.3109/15513815.2014.962197. Epub 2014 Oct 14.
OBJECTIVES
To evaluate the clinical features of fetuses with prenatally diagnosed parvovirus B19 infection and fetal hydrops.
METHODS
Parvovirus infection was diagnosed by PCR analysis of amniotic fluid or fetal blood. Fetal anemia was assessed by Doppler measurements of the middle cerebral artery peak systolic velocity (MCA-PSV) and confirmed by fetal blood. Intrauterine transfusions (IUT) were performed only if the MCA-PSV was > 1.5°MoM.
RESULTS
In our study population 10 cases of parvovirus infection which were associated with fetal hydrops were reviewed. The median gestational age at diagnosis was 21 (16.3-24.2) weeks. Five of our cases received IUT and four fetuses survived. The remaining five cases were managed conservatively and two fetuses survived.
CONCLUSIONS
The survival rate for parvovirus infection associated with fetal hydrops was 60%. MCA-PSV and IUT are useful for the management and treatment of fetal anemia due to parvovirus infection.
目的
评估产前诊断为细小病毒B19感染及胎儿水肿的胎儿的临床特征。
方法
通过羊水或胎儿血液的PCR分析诊断细小病毒感染。通过多普勒测量大脑中动脉收缩期峰值流速（MCA-PSV）评估胎儿贫血，并通过胎儿血液进行确认。仅当MCA-PSV>1.5倍中位数（MoM）时才进行宫内输血（IUT）。
结果
在我们的研究人群中，回顾了10例与胎儿水肿相关的细小病毒感染病例。诊断时的中位孕周为21（16.3-24.2）周。我们的5例病例接受了IUT，4例胎儿存活。其余5例采用保守治疗，2例胎儿存活。
结论
与胎儿水肿相关的细小病毒感染的存活率为60%。MCA-PSV和IUT对因细小病毒感染导致的胎儿贫血的管理和治疗有用。
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