Rogers B B, Singer D B, Mak S K, Gary G W, Fikrig M K, McMillan P N
Department of Pathology, Women and Infants Hospital, Providence, Rhode Island.
Obstet Gynecol. 1993 Mar;81(3):402-8.
To determine whether there is an association between parvovirus B19 infection and early spontaneous abortion at less than 20 weeks' gestation.
Eighty samples of early spontaneous abortions were analyzed. Each sample was examined histologically for the presence of viral inclusions, and selected cases were analyzed for parvovirus using electron microscopy and in situ hybridization. Polymerase chain reaction DNA amplification for the virus was done in each case. Maternal sera were analyzed for immunoglobulin (Ig) M and IgG parvovirus antibodies and compared with temporally matched controls.
Five cases in the study group had evidence of seroconversion for parvovirus, compared with two controls. Products of conception from two of these five cases were positive for virus by polymerase chain reaction amplification, and only one of these two had a characteristic inclusion of parvovirus histologically. Conversely, five chorionic vesicles from mothers who had not seroconverted had histologic changes suggesting parvovirus infection, but all of these cases were negative for parvovirus using in situ hybridization, polymerase chain reaction, and electron microscopy.
Parvovirus B19 DNA was found in two of 80 early spontaneous abortuses. Although viral DNA was detected in two cases, there was no clear evidence that the infections caused fetal death. Neither case showed erythroblastosis with large numbers of inclusions, as is seen in hydropic fetuses with parvovirus infection. In addition, in five cases in which parvovirus infection was not documented serologically or by the polymerase chain reaction, there was erythroid nuclear clearing suggestive of parvovirus B19 inclusions. This indicates that histologic evaluation for parvoviral inclusions is not always reliable in early spontaneous abortuses.
确定妊娠20周以内细小病毒B19感染与早期自然流产之间是否存在关联。
对80例早期自然流产样本进行分析。每个样本进行组织学检查以确定是否存在病毒包涵体，对选定病例使用电子显微镜和原位杂交技术分析细小病毒。对每个病例进行病毒的聚合酶链反应DNA扩增。分析孕妇血清中的细小病毒免疫球蛋白（Ig）M和IgG抗体，并与同期匹配的对照组进行比较。
研究组中有5例有细小病毒血清学转换的证据，而对照组有2例。这5例中的2例流产产物经聚合酶链反应扩增显示病毒阳性，其中仅1例在组织学上有细小病毒特征性包涵体。相反，5例未发生血清学转换的母亲的绒毛膜囊有提示细小病毒感染的组织学变化，但所有这些病例经原位杂交、聚合酶链反应和电子显微镜检查细小病毒均为阴性。
80例早期自然流产中有2例发现细小病毒B19 DNA。虽然在2例中检测到病毒DNA，但没有明确证据表明感染导致胎儿死亡。两例均未显示出如细小病毒感染的水肿胎儿中所见的大量包涵体的成红细胞增多症。此外，在5例血清学或聚合酶链反应未记录细小病毒感染的病例中，有提示细小病毒B19包涵体的红细胞核溶解。这表明在早期自然流产中，对细小病毒包涵体的组织学评估并不总是可靠的。
