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细小病毒B19感染与妊娠:当前知识综述

Parvovirus B19 Infection and Pregnancy: Review of the Current Knowledge.

作者信息

Dittmer Fernanda Parciasepe, Guimarães Clara de Moura, Peixoto Alberto Borges, Pontes Karina Felippe Monezi, Bonasoni Maria Paola, Tonni Gabriele, Araujo Júnior Edward

机构信息

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil.

Gynecology and Obstetrics Service, Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba 38050-501, MG, Brazil.

出版信息

J Pers Med. 2024 Jan 26;14(2):139. doi: 10.3390/jpm14020139.

Abstract

Parvovirus B19, a member of the family, is a human pathogenic virus. It can be transmitted by respiratory secretions, hand-to-mouth contact, blood transfusion, or transplacental transmission. Most patients are asymptomatic or present with mild symptoms such as erythema infectiosum, especially in children. In rare cases, moderate-to-severe symptoms may occur, affecting blood cells and other systems, resulting in anemia, thrombocytopenia, and neutropenia. Non-immune pregnant women are at risk for fetal infection by parvovirus B19, with greater complications if transmission occurs in the first or second trimester. Infected fetuses may not show any abnormalities in most cases, but in more severe cases, there may be severe fetal anemia, hydrops, and even pregnancy loss. Maternal diagnosis of intrauterine parvovirus B19 infection includes IgG and IgM antibody testing. For fetal diagnosis, PCR is performed through amniocentesis. In addition to diagnosing the infection, it is important to monitor the peak of systolic velocity of the middle cerebral artery (PVS-MCA) Doppler to assess the presence of fetal anemia. There is no vaccine for parvovirus B19, and fetal management focuses on detecting moderate/severe anemia by fetal PVS-MCA Doppler, which, if diagnosed, should be treated with intrauterine transfusion by cordocentesis. Prevention focuses on reducing exposure in high-risk populations, particularly pregnant women.

摘要

细小病毒B19是该病毒家族的成员之一,是一种人类致病病毒。它可通过呼吸道分泌物、手口接触、输血或经胎盘传播。大多数患者无症状或表现出轻微症状,如传染性红斑,尤其是在儿童中。在极少数情况下,可能会出现中度至重度症状,影响血细胞和其他系统,导致贫血、血小板减少和中性粒细胞减少。未免疫的孕妇有感染细小病毒B19的风险,如果在孕早期或孕中期发生传播,并发症会更多。大多数情况下,受感染的胎儿可能没有任何异常,但在更严重的情况下,可能会出现严重的胎儿贫血、水肿,甚至流产。孕妇宫内细小病毒B19感染的诊断包括IgG和IgM抗体检测。对于胎儿诊断,通过羊膜穿刺术进行PCR检测。除了诊断感染外,监测大脑中动脉收缩期峰值速度(PVS-MCA)多普勒以评估胎儿贫血的存在也很重要。目前没有针对细小病毒B19的疫苗,胎儿管理重点是通过胎儿PVS-MCA多普勒检测中度/重度贫血,如果确诊,应通过脐静脉穿刺进行宫内输血治疗。预防重点是减少高危人群,特别是孕妇的接触。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb0/10890458/18fe73b36eff/jpm-14-00139-g001.jpg

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