Lynch L, Ghidini A
Mount Sinai School of Medicine, New York, New York.
Curr Opin Obstet Gynecol. 1993 Feb;5(1):24-32.
Information concerning the most recently discovered infections with perinatal implications is constantly expanding. Hepatitis C virus is responsible for the majority of cases of sporadic and transfusion-related non-A, non-B hepatitis. Its prevalence in the general obstetric population is approximately 2%, but it is much higher in intravenous drug users and recipients of blood transfusions. The risk of vertical transmission is probably small (approximately 4.5%), but mothers coinfected with hepatitis C virus and human immunodeficiency virus type 1 are at higher risk of transmitting infection, possibly as a result of higher levels of viremia. Parvovirus B19 infection can jeopardize the fetus in approximately 9% of cases, leading to profound anemia, followed by hydrops and death. B19 has not been proven to be teratogenic, but survivors have a greater risk of in utero growth retardation. Cytomegalovirus remains the most common cause of congenital infections, and the fetal effects of primary maternal infection during gestation can be devastating. Recurrent infections carry a much lower risk of vertical transmission. Prenatal diagnosis is feasible and reliable. The factors affecting the vertical transmission of human immunodeficiency virus type 1 have been further delineated, and new avenues of research have been opened.
有关最新发现的具有围产期影响的感染的信息在不断增加。丙型肝炎病毒是散发性和输血相关的非甲非乙型肝炎的主要病因。其在普通产科人群中的患病率约为2%，但在静脉吸毒者和输血接受者中要高得多。垂直传播的风险可能较小（约4.5%），但同时感染丙型肝炎病毒和1型人类免疫缺陷病毒的母亲传播感染的风险更高，这可能是由于病毒血症水平较高所致。细小病毒B19感染在约9%的病例中会危及胎儿，导致严重贫血，继而出现水肿和死亡。尚未证实B19具有致畸性，但存活者在子宫内生长迟缓的风险更大。巨细胞病毒仍然是先天性感染的最常见病因，孕期母亲初次感染对胎儿的影响可能是毁灭性的。复发性感染的垂直传播风险要低得多。产前诊断可行且可靠。影响1型人类免疫缺陷病毒垂直传播的因素已得到进一步明确，并且开辟了新的研究途径。
