Abstract：
UNASSIGNED: Although the risk of parvovirus B19 infection during pregnancy and subsequent risk of adverse fetal outcome are low, understanding management practices is essential for proper treatment of fetuses with nonimmune hydrops fetalis. In addition, continued investigation into delivery management, breastfeeding recommendations, and congenital abnormalities associated with pregnancies complicated by parvovirus B19 infection is needed.
UNASSIGNED: This review describes the risks associated with parvovirus B19 infection during pregnancy and the management strategies for fetuses with vertically transmitted infections.
UNASSIGNED: Original articles were obtained from literature search in PubMed, Medline, and OVID; pertinent articles were reviewed.
UNASSIGNED: Parvovirus B19 is a viral infection associated with negative pregnancy outcomes. Up to 50% of people of reproductive age are susceptible to the virus. The incidence of B19 in pregnancy is between 0.61% and 1.24%, and, overall, there is 30% risk of vertical transmission when infection is acquired during pregnancy. Although most pregnancies progress without negative outcomes, viral infection of the fetus may result in severe anemia, congestive heart failure, and hydrops fetalis. In addition, vertical transmission carries a 5% to 10% chance of fetal loss. In pregnancies affected by fetal B19 infection, Doppler examination of the middle cerebral artery peak systolic velocity should be initiated to surveil for fetal anemia. In the case of severe fetal anemia, standard fetal therapy involves an intrauterine transfusion of red blood cells with the goal of raising hematocrit levels to approximately 40% to 50% of total blood volume. One transfusion is usually sufficient, although continued surveillance may indicate the need for subsequent transfusions. There are fewer epidemiologic data concerning neonatal risks of congenital parvovirus, although case reports have shown that fetuses with severe anemia in utero may have persistent anemia, thrombocytopenia, and edema in the neonatal period.
UNASSIGNED: Parvovirus B19 is a common virus; seropositivity in the geriatric population reportedly reaches 85%. Within the pregnant population, up to 50% of patients have not previously been exposed to the virus and consequently lack protective immunity. Concern for parvovirus B19 infection in pregnancy largely surrounds the consequences of vertical transmission of the virus to the fetus. Should vertical transmission occur, the overall risk of fetal loss is between 5% and 10%. Thus, understanding the incidence, risks, and management strategies of pregnancies complicated by parvovirus B19 is essential to optimizing care and outcomes. Further, there is currently a gap in evidence regarding delivery management, breastfeeding recommendations, and the risks of congenital abnormalities in pregnancies complicated by parvovirus B19. Additional investigations into optimal delivery management, feeding plans, and recommended neonatal surveillance are needed in this cohort of patients.
UNASSIGNED: This review describes the risks associated with parvovirus B19 infection during pregnancy and the management strategies for fetuses with vertically transmitted infections.
UNASSIGNED: Original articles were obtained from literature search in PubMed, Medline, and OVID; pertinent articles were reviewed.
UNASSIGNED: Parvovirus B19 is a viral infection associated with negative pregnancy outcomes. Up to 50% of people of reproductive age are susceptible to the virus. The incidence of B19 in pregnancy is between 0.61% and 1.24%, and, overall, there is 30% risk of vertical transmission when infection is acquired during pregnancy. Although most pregnancies progress without negative outcomes, viral infection of the fetus may result in severe anemia, congestive heart failure, and hydrops fetalis. In addition, vertical transmission carries a 5% to 10% chance of fetal loss. In pregnancies affected by fetal B19 infection, Doppler examination of the middle cerebral artery peak systolic velocity should be initiated to surveil for fetal anemia. In the case of severe fetal anemia, standard fetal therapy involves an intrauterine transfusion of red blood cells with the goal of raising hematocrit levels to approximately 40% to 50% of total blood volume. One transfusion is usually sufficient, although continued surveillance may indicate the need for subsequent transfusions. There are fewer epidemiologic data concerning neonatal risks of congenital parvovirus, although case reports have shown that fetuses with severe anemia in utero may have persistent anemia, thrombocytopenia, and edema in the neonatal period.
UNASSIGNED: Parvovirus B19 is a common virus; seropositivity in the geriatric population reportedly reaches 85%. Within the pregnant population, up to 50% of patients have not previously been exposed to the virus and consequently lack protective immunity. Concern for parvovirus B19 infection in pregnancy largely surrounds the consequences of vertical transmission of the virus to the fetus. Should vertical transmission occur, the overall risk of fetal loss is between 5% and 10%. Thus, understanding the incidence, risks, and management strategies of pregnancies complicated by parvovirus B19 is essential to optimizing care and outcomes. Further, there is currently a gap in evidence regarding delivery management, breastfeeding recommendations, and the risks of congenital abnormalities in pregnancies complicated by parvovirus B19. Additional investigations into optimal delivery management, feeding plans, and recommended neonatal surveillance are needed in this cohort of patients.
摘要：
■尽管在怀孕期间感染细小病毒B19的风险以及随后的不良胎儿结局的风险很低，了解管理实践对于正确治疗患有非免疫性胎儿水肿的胎儿至关重要。此外,继续调查交付管理，母乳喂养建议,与妊娠合并细小病毒B19感染相关的先天性异常是必要的。
■这篇综述描述了怀孕期间与细小病毒B19感染相关的风险以及垂直传播感染胎儿的管理策略。
■原始文章来自PubMed的文献检索，Medline,和OVID；相关文章进行了综述。
■细小病毒B19是一种与阴性妊娠结局相关的病毒感染。多达50％的育龄人群对该病毒易感。B19在妊娠期的发病率在0.61%到1.24%之间,and,总的来说,当怀孕期间获得感染时，有30％的垂直传播风险。虽然大多数怀孕进展没有负面结果，胎儿的病毒感染可能导致严重的贫血，充血性心力衰竭,和胎儿水肿。此外,垂直传播有5%到10%的胎儿丢失几率。在受胎儿B19感染影响的怀孕中，应开始对大脑中动脉收缩期峰值速度进行多普勒检查，以监测胎儿贫血。在严重的胎儿贫血的情况下，标准的胎儿治疗包括宫内输血红细胞,目的是将血细胞比容水平提高到约40%~50%.一次输血通常就足够了,尽管继续监测可能表明需要后续输血。关于先天性细小病毒的新生儿风险的流行病学数据较少，尽管病例报告显示子宫内严重贫血的胎儿可能有持续性贫血，血小板减少症,在新生儿期水肿。
■细小病毒B19是一种常见病毒；据报道，老年人群中的血清阳性率达到85％。在怀孕人群中，多达50％的患者以前没有接触过病毒，因此缺乏保护性免疫力。对妊娠中细小病毒B19感染的关注主要围绕病毒垂直传播给胎儿的后果。如果发生垂直传输，胎儿丢失的总体风险在5%至10%之间。因此，了解发病率，风险,和妊娠合并细小病毒B19的管理策略对于优化护理和结局至关重要。Further,目前在交付管理方面存在证据空白，母乳喂养建议,以及妊娠合并细小病毒B19的先天性异常的风险。对最佳交付管理的额外调查，喂养计划，并建议在这一队列患者中进行新生儿监护.
■这篇综述描述了怀孕期间与细小病毒B19感染相关的风险以及垂直传播感染胎儿的管理策略。
■原始文章来自PubMed的文献检索，Medline,和OVID；相关文章进行了综述。
■细小病毒B19是一种与阴性妊娠结局相关的病毒感染。多达50％的育龄人群对该病毒易感。B19在妊娠期的发病率在0.61%到1.24%之间,and,总的来说,当怀孕期间获得感染时，有30％的垂直传播风险。虽然大多数怀孕进展没有负面结果，胎儿的病毒感染可能导致严重的贫血，充血性心力衰竭,和胎儿水肿。此外,垂直传播有5%到10%的胎儿丢失几率。在受胎儿B19感染影响的怀孕中，应开始对大脑中动脉收缩期峰值速度进行多普勒检查，以监测胎儿贫血。在严重的胎儿贫血的情况下，标准的胎儿治疗包括宫内输血红细胞,目的是将血细胞比容水平提高到约40%~50%.一次输血通常就足够了,尽管继续监测可能表明需要后续输血。关于先天性细小病毒的新生儿风险的流行病学数据较少，尽管病例报告显示子宫内严重贫血的胎儿可能有持续性贫血，血小板减少症,在新生儿期水肿。
■细小病毒B19是一种常见病毒；据报道，老年人群中的血清阳性率达到85％。在怀孕人群中，多达50％的患者以前没有接触过病毒，因此缺乏保护性免疫力。对妊娠中细小病毒B19感染的关注主要围绕病毒垂直传播给胎儿的后果。如果发生垂直传输，胎儿丢失的总体风险在5%至10%之间。因此，了解发病率，风险,和妊娠合并细小病毒B19的管理策略对于优化护理和结局至关重要。Further,目前在交付管理方面存在证据空白，母乳喂养建议,以及妊娠合并细小病毒B19的先天性异常的风险。对最佳交付管理的额外调查，喂养计划，并建议在这一队列患者中进行新生儿监护.
