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先天性细小病毒B19感染的识别与管理

Identification and management of congenital parvovirus B19 infection.

作者信息

Attwood Lucy O, Holmes Natasha E, Hui Lisa

机构信息

Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.

Department of Perinatal Medicine, Mercy Hospital for Women, Melbourne, Victoria, Australia.

出版信息

Prenat Diagn. 2020 Dec;40(13):1722-1731. doi: 10.1002/pd.5819. Epub 2020 Sep 30.

Abstract

Parvovirus B19 (B19V) infection is well known for its mild, self-limiting clinical presentations in children, such as erythema infectiosum. Approximately 40% of women of childbearing age are susceptible to B19V infection. While maternal B19V infection usually has a good prognosis, B19V can cause severe fetal anaemia and pregnancy loss due to its ability to suppress erythroid progenitor cells. Non-invasive ultrasound monitoring for fetal anaemia is usually performed if maternal seroconversion occurs in the first 20 weeks of gestation, with amniocentesis for fetal infection reserved for those who first present with fetal anaemia or hydrops of unknown cause. Intrauterine transfusion is the standard treatment for severe fetal anaemia and is associated with a significant improvement in survival. However, survivors of hydrops fetalis may have a higher rate of long-term neurodevelopmental complications compared with non-hydropic survivors. This review aims to synthesise published data on the diagnosis, surveillance and outcomes of congenital parvovirus infection to assist clinicians in diagnosing and managing this important condition.

摘要

细小病毒B19(B19V)感染因其在儿童中表现为轻度、自限性临床症状而闻名,如传染性红斑。约40%的育龄妇女易感染B19V。虽然孕妇感染B19V通常预后良好,但由于B19V能够抑制红系祖细胞,可导致严重的胎儿贫血和流产。如果孕妇在妊娠前20周发生血清学转换,通常会进行无创超声监测胎儿贫血情况,对于首次出现不明原因的胎儿贫血或水肿者,则进行羊膜腔穿刺术检测胎儿感染情况。宫内输血是治疗严重胎儿贫血的标准方法,可显著提高生存率。然而,与非水肿幸存者相比,胎儿水肿幸存者长期神经发育并发症的发生率可能更高。本综述旨在综合已发表的关于先天性细小病毒感染的诊断、监测和结局的数据,以协助临床医生诊断和管理这一重要病症。

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