Rosenberg H S
Department of Pediatrics, University of Texas Medical School, Houston 77225.
Am J Cardiovasc Pathol. 1987;1(2):147-56.
In the course of gestation, many bacteria, parasites, and viruses may infect the pregnant woman, but few cross the placenta to affect the fetus and fewer still affect the fetal heart. Although the incidence of fetal cardiac infection is low, the effect on the fetus is major. In terms of frequency, rubella virus, Toxoplasma gondii, and Coxsackie virus B are the principal infectious agents affecting the fetal heart, but any number of organisms may cross the placenta to affect the fetus. The pathogenesis of infection of the fetal heart relates to the agent and to the time of gestation when the infection occurs. The agent affects the heart along one or more of three separate pathways: inhibition of cell growth, cytolysis, and interference with the blood supply. Most agents cause cytolysis, stimulating inflammation and scarring. Although several agents carry the suspicion of teratogenicity, only rubella virus has been incriminated with certainty as capable of functioning along each of the three pathways with the potential to serve as teratogen.
在妊娠过程中，许多细菌、寄生虫和病毒可能感染孕妇，但很少有能穿过胎盘影响胎儿的，更少会影响胎儿心脏。尽管胎儿心脏感染的发生率较低，但对胎儿的影响却很大。就感染频率而言，风疹病毒、弓形虫和柯萨奇B病毒是影响胎儿心脏的主要感染源，但任何数量的病原体都可能穿过胎盘影响胎儿。胎儿心脏感染的发病机制与病原体以及感染发生时的妊娠时间有关。病原体沿着三条不同途径中的一条或多条影响心脏：抑制细胞生长、细胞溶解以及干扰血液供应。大多数病原体引起细胞溶解，刺激炎症和瘢痕形成。尽管有几种病原体被怀疑具有致畸性，但只有风疹病毒被明确认定能够通过这三条途径发挥作用并具有致畸潜力。
