Savey L, Poissonnier M H, Leblanc M, Colau J C
Service de Gynécologie-Obstétrique, CMC Foch, Suresnes.
J Gynecol Obstet Biol Reprod (Paris). 1995;24(2):170-6.
Parvovirus B19 was identified in 1975. It causes infections megalerythemia in adults associated with skin eruptions and joint pain (about 50% of the adult population is immunized). The risk of contamination in case of an epidemia is high in school teachers and school personnel. In 1984, the parvovirus B19 was implicated as the cause of fetal anasarca. The risk of transplacental contamination is estimated at 33% in case of maternal infection. Pregnant women with parvovirus B19 infection and confirmed serology should have an echography every 15 days. Fetal anasarca can be complicated by in utero fetal death related to erythroid stem-cell anaemia. The diagnosis of fetal infection is based on PCR techniques on fetal blood. Symptomatic antenatal treatment with in utero transfusion was proposed as early as 1988. This method does not however appear to be necessary in all cases as the outcome in several reports of untreated fetuses was delivery of a normal child. There is the possibility of myocardial damage caused by parvovirus B19 which would make in utero transfusion difficult and limit its beneficial effect. Finally associated thrombopenia is often severe and increased fetal risk.
细小病毒B19于1975年被发现。它可导致成人感染性巨红斑，伴有皮疹和关节疼痛（约50%的成年人口已免疫）。在疫情爆发时，学校教师和学校工作人员受感染的风险很高。1984年，细小病毒B19被认为是胎儿全身性水肿的病因。孕妇感染时，经胎盘感染的风险估计为33%。感染细小病毒B19且血清学检查确诊的孕妇应每15天进行一次超声检查。胎儿全身性水肿可能因与红系干细胞贫血相关的宫内胎儿死亡而复杂化。胎儿感染的诊断基于对胎儿血液进行的PCR技术。早在1988年就有人提出对有症状的胎儿进行宫内输血的产前治疗。然而，在所有情况下这种方法似乎并非都有必要，因为在一些未治疗胎儿的报告中，结果是产下了正常的婴儿。存在细小病毒B19导致心肌损伤的可能性，这会使宫内输血变得困难并限制其有益效果。最后，相关的血小板减少症往往很严重，会增加胎儿风险。
