Hwa H L, Shyu M K, Lee C N, Wu C C, Kao C L, Hsieh F J
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
Obstet Gynecol. 1994 Sep;84(3):415-9.
To determine the frequency of intrauterine rubella infection in Taiwan.
One hundred three pregnant women with evidence of rubella infection were enrolled. Congenital rubella infection was diagnosed by testing specific immunoglobulin (Ig) M in fetal cord serum obtained from funipuncture or amniotic fluid culture. The fetal outcomes were evaluated by ultrasonic examination, specific antibody detection in cord blood at birth, and complete physical examination during early childhood.
Prenatal diagnosis was possible in 95 of 103 fetuses, 93 by funipuncture and two by amniocentesis. Five intrauterine rubella infections were detected prenatally, and another one was diagnosed after birth. The intrauterine infection rates were 10.0, 11.8, 2.9, and 6.5% after maternal infection at 1-10, 11-14, 15-19, and 20-29 gestational weeks, respectively. Among the six fetuses with serologic evidence of congenital infection, one had congenital rubella syndrome with sensorineural deafness, two were terminated during the second trimester, two others were normal, and one was lost to follow-up. With the exception of the infant with clinical congenital rubella syndrome, no evidence of rubella defects was found in the other 81 children who received follow-up to 2-4 years old.
The risk of congenital rubella infection in seropositive pregnant women is relatively low in Taiwan.
确定台湾地区宫内风疹感染的发生率。
纳入103例有风疹感染证据的孕妇。通过检测经脐血穿刺获取的胎儿脐血血清中的特异性免疫球蛋白（Ig）M或羊水培养来诊断先天性风疹感染。通过超声检查、出生时脐血特异性抗体检测以及幼儿期的全面体格检查来评估胎儿结局。
103例胎儿中有95例可进行产前诊断，93例通过脐血穿刺，2例通过羊膜腔穿刺。产前检测到5例宫内风疹感染，另1例在出生后被诊断。孕妇在妊娠1 - 10周、11 - 14周、15 - 19周和20 - 29周感染风疹后，宫内感染率分别为10.0%、11.8%、2.9%和6.5%。在6例有先天性感染血清学证据的胎儿中，1例患有先天性风疹综合征伴感音神经性耳聋，2例在孕中期终止妊娠，另外2例正常，1例失访。除了患有临床先天性风疹综合征的婴儿外，在随访至2 - 4岁的其他81名儿童中未发现风疹缺陷的证据。
在台湾地区，血清学阳性孕妇发生先天性风疹感染的风险相对较低。
