Kagan Karl Oliver, Hamprecht Klaus
Department of obstetrics and gynecology, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
Institute for Medical Virology and Epidemiology of Viral Diseases, University of Tuebingen, Elfriede-Aulhorn-Straße 6, 72076, Tübingen, Germany.
Arch Gynecol Obstet. 2017 Jul;296(1):15-26. doi: 10.1007/s00404-017-4380-2. Epub 2017 May 15.
Due to the severe risk of long-term sequelae, prenatal cytomegalovirus infection is of particular importance amongst intrauterine viral infections. This review summarizes the current knowledge about CMV infection in pregnancy.
A search of the Medline and Embase database was done for articles about CMV infection in pregnany. We performed a detailed review of the literature in view of diagnosis, epidemiology and management of CMV infection in pregnancy.
The maternal course of the infection is predominantly asymptomatic; the infection often remains unrecognized until the actual fetal manifestation. Typical ultrasound signs that should arouse suspicion of intrauterine CMV infection can be distinguished into CNS signs such as ventriculomegaly or microcephaly and extracerebral infection signs such as hepatosplenomegaly or hyperechogenic bowel. Current treatment strategies focus on hygienic measures to prevent a maternal CMV infection during pregnancy, on maternal application of hyperimmunoglobulines to avoid materno-fetal transmission in case of a maternal seroconversion, and on an antiviral therapy in case the materno-fetal transmission have occurred.
CMV infection in pregnancy may result in a severe developmental disorder of the newborn. This should be taken into account in the treatment of affected and non-affected pregnant women.
由于存在长期后遗症的严重风险,产前巨细胞病毒感染在宫内病毒感染中尤为重要。本综述总结了目前关于孕期巨细胞病毒感染的知识。
在Medline和Embase数据库中检索关于孕期巨细胞病毒感染的文章。我们针对孕期巨细胞病毒感染的诊断、流行病学和管理对文献进行了详细综述。
感染的母亲病程主要为无症状;该感染往往在实际出现胎儿表现之前未被识别。应引起对宫内巨细胞病毒感染怀疑的典型超声征象可分为中枢神经系统征象,如脑室扩大或小头畸形,以及脑外感染征象,如肝脾肿大或肠壁回声增强。当前的治疗策略侧重于采取卫生措施预防孕期母亲感染巨细胞病毒,在母亲血清学转换时应用高效免疫球蛋白以避免母婴传播,以及在发生母婴传播时进行抗病毒治疗。
孕期巨细胞病毒感染可能导致新生儿严重发育障碍。在治疗受影响和未受影响的孕妇时应考虑到这一点。