细小病毒B19是细小病毒科的一员,是一种人类致病病毒。它可以通过呼吸道分泌物传播,手-口接触,输血,或经胎盘传播。大多数患者无症状或出现轻度症状,如感染性红斑,尤其是儿童。在极少数情况下,可能出现中度至重度症状,影响血细胞和其他系统,导致贫血,血小板减少症,和中性粒细胞减少症.非免疫孕妇有胎儿感染细小病毒B19的风险,如果在妊娠早期或中期传播,并发症会更大。在大多数情况下,受感染的胎儿可能不会出现任何异常,但是在更严重的情况下,可能有严重的胎儿贫血,积水,甚至怀孕失败。宫内细小病毒B19感染的母体诊断包括IgG和IgM抗体检测。为了诊断胎儿,通过羊膜穿刺术进行PCR。除了诊断感染,重要的是监测大脑中动脉(PVS-MCA)多普勒的收缩期速度峰值,以评估胎儿贫血的存在。目前尚无针对细小病毒B19的疫苗,胎儿管理重点是通过胎儿PVS-MCA多普勒检测中度/重度贫血,which,如果诊断出来,应通过宫腔穿刺术进行宫内输血治疗。预防的重点是减少高危人群的暴露,尤其是孕妇。
Parvovirus B19, a member of the Parvoviridae family, is a human pathogenic virus. It can be transmitted by respiratory secretions, hand-to-mouth contact, blood transfusion, or transplacental transmission. Most patients are asymptomatic or present with mild symptoms such as erythema infectiosum, especially in children. In rare cases, moderate-to-severe symptoms may occur, affecting blood cells and other systems, resulting in anemia, thrombocytopenia, and neutropenia. Non-immune pregnant women are at risk for fetal infection by parvovirus B19, with greater complications if transmission occurs in the first or second trimester. Infected fetuses may not show any abnormalities in most cases, but in more severe cases, there may be severe fetal anemia, hydrops, and even pregnancy loss. Maternal diagnosis of intrauterine parvovirus B19 infection includes IgG and IgM antibody testing. For fetal diagnosis, PCR is performed through amniocentesis. In addition to diagnosing the infection, it is important to monitor the peak of systolic velocity of the middle cerebral artery (PVS-MCA) Doppler to assess the presence of fetal anemia. There is no vaccine for parvovirus B19, and fetal management focuses on detecting moderate/severe anemia by fetal PVS-MCA Doppler, which, if diagnosed, should be treated with intrauterine transfusion by cordocentesis. Prevention focuses on reducing exposure in high-risk populations, particularly pregnant women.