Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, 178 rue des Renouillers, 92701, Colombes cedex, France.
Université de Paris, Paris, France.
Prenat Diagn. 2020 Mar;40(4):408-414. doi: 10.1002/pd.5587. Epub 2020 Jan 2.
Herpes simplex virus (HSV) infection during pregnancy can cause severe neonatal infections. It is also a rare cause of congenital infections. We aimed to describe fetal and neonatal abnormalities of congenital HSV infection in order to define the features that are accessible to prenatal diagnosis during ultrasound screening and/or during a work-up for congenital malformations.
We analysed all cases of congenital HSV infection (CHI) described before and/or after birth and identified in Pubed and classified the findings as accessible or not to prenatal diagnosis.
Thirty-six cases of congenital herpes infection were reported, of which 15 were described prenatally and 21 postnatally. The most frequently reported malformations accessible to prenatal diagnosis were cerebral anomalies. The most common abnormalities described after birth were skin lesions and keratitis, which are not considered amenable to prenatal ultrasound detection. CHI can due to either HSV1 or HSV2 infection, whether primary or non-primary infection, with or without the presence of maternal symptoms.
Prenatal ultrasound abnormalities due to CHI are rare, varied and non-specific. There is no clear role for fetal ultrasound in the routine management of women with primary or non-primary HSV infection in pregnancy. However, in fetuses with ultrasound abnormalities suggestive of congenital infection, HSV should still be considered as a differential diagnosis after the more common in utero infections, such as cytomegalovirus, are excluded.
孕妇单纯疱疹病毒（HSV）感染可导致严重的新生儿感染。它也是罕见的先天性感染原因之一。我们旨在描述先天性 HSV 感染的胎儿和新生儿异常，以确定在超声筛查期间和/或在先天性畸形检查期间可进行产前诊断的特征。
我们分析了在 Pubmed 上描述的所有先天性 HSV 感染（CHI）病例，并对其进行了分类，将这些发现分为可进行或不可进行产前诊断。
报告了 36 例先天性疱疹感染病例，其中 15 例在产前描述，21 例在产后描述。最常报道的可进行产前诊断的畸形是脑异常。出生后最常见的异常是皮肤损伤和角膜炎，这些异常不能通过产前超声检测到。CHI 可由 HSV1 或 HSV2 感染引起，无论是原发性还是非原发性感染，有无母体症状。
由 CHI 引起的产前超声异常罕见、多样且无特异性。对于原发性或非原发性 HSV 感染孕妇，胎儿超声在常规管理中没有明确作用。然而，对于超声异常提示先天性感染的胎儿，在排除更常见的宫内感染（如巨细胞病毒）后，仍应将 HSV 作为鉴别诊断。
