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风疹病毒或巨细胞病毒引起的胎儿感染:母体血清学特征、侵入性诊断程序与长期随访之间的相关性

Fetal infection from rubeovirus or cytomegalovirus: correlation among maternal serological profiles, invasive diagnostic procedures, and long-term follow-up.

作者信息

Noia G, Masini L, De Santis M, Scavo M, Pomini F, Grillo R, Cattani P, Ranno O, Caruso A, Mancuso S

机构信息

Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy.

出版信息

J Matern Fetal Med. 1998 Jan-Feb;7(1):36-42. doi: 10.1002/(SICI)1520-6661(199801/02)7:1<36::AID-MFM9>3.0.CO;2-S.

Abstract

Different variables influence the possibility that maternal viral infection may be transmitted to the fetus, although not all fetal infections result in fetal "illness" with consequent fetopathy. As concerns the fetus, prenatal diagnosis includes invasive techniques necessary for fetal tissue sampling. These techniques carry some risks. The fetal infectious risk, as determined by maternal clinico-serological profile and according to sonographic investigation, always should be weighed against the risks and benefits of invasive diagnostic procedures. The present study re-elaborates the criteria necessary for defining fetal risk as related to the maternal serological profile. In the 26 mothers with rubeola infection, the incidence of fetal mortality was 7.7%. Fetal prognosis worsens with the precocity of eruption. In these cases the esantema is the most reliable prognostic element as an indication to perform the invasive procedure. In the 15 patients with cytomegalovirus infection, no fetal or postnatal losses occurred. Morbidity occurred in 13.3% of cases, and the two ill fetuses were classified in the same risk group. In this group of patients, the maternal serological profile is a significant predictor of fetal morbidity.

摘要

不同的变量会影响母体病毒感染传播给胎儿的可能性,尽管并非所有胎儿感染都会导致胎儿“患病”并随之出现胎儿病变。就胎儿而言,产前诊断包括胎儿组织采样所需的侵入性技术。这些技术存在一定风险。根据母体临床血清学特征并依据超声检查确定的胎儿感染风险,始终应与侵入性诊断程序的风险和益处进行权衡。本研究重新阐述了与母体血清学特征相关的定义胎儿风险所需的标准。在26例患风疹感染的母亲中,胎儿死亡率为7.7%。胎儿预后会随着皮疹出现的早熟而恶化。在这些病例中,皮疹是作为进行侵入性操作指征的最可靠预后因素。在15例患巨细胞病毒感染的患者中,未发生胎儿或产后死亡。13.3%的病例出现了发病情况,且两名患病胎儿被归为同一风险组。在这组患者中,母体血清学特征是胎儿发病的重要预测指标。

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