Qureshi F, Jacques S M
Department of Pathology, Hutzel Hospital, Detroit, MI 48201, USA.
Hum Pathol. 1996 Feb;27(2):191-5. doi: 10.1016/s0046-8177(96)90374-3.
The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.
作者检查了73名孕期诊断为水痘的女性的记录，以将胎盘检查结果与母亲病史及胎儿结局相关联。其中58名母亲在作者所在机构分娩，19份胎盘可供检查。水痘症状出现时间从分娩前27周直至产后1天。在作者所在机构分娩的新生儿中，仅1例出生时被诊断为可能患水痘；其余新生儿无明确感染证据；不过，大多数新生儿未进行血清学研究。可能患水痘的新生儿的胎盘显示广泛的基底慢性绒毛炎，伴有淋巴细胞和组织细胞浸润以及偶尔的多核巨细胞。另外两份胎盘显示罕见的慢性绒毛炎病灶，其余胎盘未显示绒毛炎或其他病毒相关变化。73名女性中有24名（33%）发生水痘肺炎，1名女性死亡。虽然孕期水痘与母亲高发病率相关，但胎儿患病并不常见。大多数胎盘未显示病毒相关病变；然而，伴有多核巨细胞的慢性绒毛炎以及母亲近期水痘病史可能提示新生儿感染。
