اهم الاصابات الفيروسيه خلال فترة الحمل
اتمنى ان تنال إعجابكم
• Healthy pregnant women are not at special risk for disease from CMV infection. When infected with CMV, most women have no symptoms and very few have a disease resembling mononucleosis.
• CMV remains the most important cause of congenital viral infection. For infants who are infected by their mothers before birth, two potential problems exist:
At birth most (85-90%) children are normal. However 5% to 10% of infants who are infected but without symptoms at birth will subsequently have varying degrees of hearing and mental or coordination problems
Of the remaining 10-15% generalized infection may occur, and symptoms may range from moderate enlargement of the liver and spleen (with jaundice) to fatal illness (see below)
Most women who are infected with parvovirus B19 infection during pregnancy have a satisfactory outcome.
• However, gestational parvovirus B19 infection has been associated with adverse consequences such as fetal death and occasionally hydrops fetalis resulting from viral replication in the bone marrow.
• It is estimated that parvovirus B19 infection in pregnancy causes fetal loss in 9 per cent of pregnancies in which infection occurs during the first 20 weeks and
• hydrops fetalis in 3 per cent of pregnancies in which infection occurred between 9 and 20 weeks.
• the risk of fetal loss in women with asymptomatic infection appears to be similar to that in women with a rash.
• Fetal infection without fetal loss or hydrops is common.
• There is no evidence of B19-associated congenital abnormality in the newborn or developmental abnormalities appearing later in childhood.
• In utero blood transfusions have been shown to be successful in treating B19 hydrops fetalis, Spontaneous recovery of hydropic fetuses may occur with subsequent delivery of a normal infant.
HSV infections during pregnancy are rarely associated with disseminated disease of the visceral organs of the mother, especially the liver.
• In the UK the incidence of neonatal herpes is ~1.65 per 100,000 live births.
• Primary or initial infection during the first or second trimester is not associated with a significant risk to the foetus. However congenital infection has been documented, the risk increases in the third trimester.
• Congenital infection can lead to foetal loss or overt disease in newborn infant.
• Most commonly neonatal infection is via the birth canal and disease is evident 3-21 days post delivery.
• If a mother has recently acquired genital herpes, the risk of transmission to the infant is 10 times greater than if she has a latent form of the virus.
Neonatal disease can manifest as three different forms of illness.
• a mild, localized infection of the skin
• CNS infection (high mortality)
• or a disseminated one (high mortality)
The risk to a foetus is highest in the first few weeks of pregnancy and then declines in terms of both frequency and severity, although there is still some risk in second trimester. The virus infects the placenta and then spreads to the foetus. If non-immune mothers are infected in the first trimester, up to 80% of neonates may have sequelae.
The sequelae of congenital rubella syndrome are:
• Hearing loss. This is the most common sequella of congenital rubella infection especially when the latter occurs after four months of pregnancy.
• Congenital heart defects such as ductus arteriosis and others
• Neurologic problems (psychomotor retardation, mental retardation, microvephaly)
• Ophthalmic problems (cataract, glaucoma, retinopathy, microphthalmia - table 1)
• intrauterine growth retardation
• Thrombocytopenia purpura (table 1)
• Hepatomegaly
• Splenomegaly
There may also be variety of other problems including bone lesions, pneumonitis etc.
In most cases, there is neural involvement - lethargy, irritability, motor tone problems, mental retardation, motor disabilities, abnormal posture, neurosensory hearing loss.
Varicella infection in pregnant women can cause severe chickenpox with increased risks of varicella pneumonia.
The fetus is at risk of Congenital Varicella Syndrome (CVS) if infection occurs in the first 20 weeks of pregnancy (risk 1-2%). CVS can cause a range of problems including limb shortening, skin scarring, cataracts and growth retardation.
Infection with varicella in the later stages of pregnancy can cause premature delivery or neonatal chickenpox infection. This is particularly serious if the mother becomes infected 7 days before birth. For these reasons, pregnant women exposed to VZV are offered IgG testing and the neonates are given immunoglobulin to help fight the infection.
اتمنى ان تنال إعجابكم
• Healthy pregnant women are not at special risk for disease from CMV infection. When infected with CMV, most women have no symptoms and very few have a disease resembling mononucleosis.
• CMV remains the most important cause of congenital viral infection. For infants who are infected by their mothers before birth, two potential problems exist:
At birth most (85-90%) children are normal. However 5% to 10% of infants who are infected but without symptoms at birth will subsequently have varying degrees of hearing and mental or coordination problems
Of the remaining 10-15% generalized infection may occur, and symptoms may range from moderate enlargement of the liver and spleen (with jaundice) to fatal illness (see below)
Most women who are infected with parvovirus B19 infection during pregnancy have a satisfactory outcome.
• However, gestational parvovirus B19 infection has been associated with adverse consequences such as fetal death and occasionally hydrops fetalis resulting from viral replication in the bone marrow.
• It is estimated that parvovirus B19 infection in pregnancy causes fetal loss in 9 per cent of pregnancies in which infection occurs during the first 20 weeks and
• hydrops fetalis in 3 per cent of pregnancies in which infection occurred between 9 and 20 weeks.
• the risk of fetal loss in women with asymptomatic infection appears to be similar to that in women with a rash.
• Fetal infection without fetal loss or hydrops is common.
• There is no evidence of B19-associated congenital abnormality in the newborn or developmental abnormalities appearing later in childhood.
• In utero blood transfusions have been shown to be successful in treating B19 hydrops fetalis, Spontaneous recovery of hydropic fetuses may occur with subsequent delivery of a normal infant.
HSV infections during pregnancy are rarely associated with disseminated disease of the visceral organs of the mother, especially the liver.
• In the UK the incidence of neonatal herpes is ~1.65 per 100,000 live births.
• Primary or initial infection during the first or second trimester is not associated with a significant risk to the foetus. However congenital infection has been documented, the risk increases in the third trimester.
• Congenital infection can lead to foetal loss or overt disease in newborn infant.
• Most commonly neonatal infection is via the birth canal and disease is evident 3-21 days post delivery.
• If a mother has recently acquired genital herpes, the risk of transmission to the infant is 10 times greater than if she has a latent form of the virus.
Neonatal disease can manifest as three different forms of illness.
• a mild, localized infection of the skin
• CNS infection (high mortality)
• or a disseminated one (high mortality)
The risk to a foetus is highest in the first few weeks of pregnancy and then declines in terms of both frequency and severity, although there is still some risk in second trimester. The virus infects the placenta and then spreads to the foetus. If non-immune mothers are infected in the first trimester, up to 80% of neonates may have sequelae.
The sequelae of congenital rubella syndrome are:
• Hearing loss. This is the most common sequella of congenital rubella infection especially when the latter occurs after four months of pregnancy.
• Congenital heart defects such as ductus arteriosis and others
• Neurologic problems (psychomotor retardation, mental retardation, microvephaly)
• Ophthalmic problems (cataract, glaucoma, retinopathy, microphthalmia - table 1)
• intrauterine growth retardation
• Thrombocytopenia purpura (table 1)
• Hepatomegaly
• Splenomegaly
There may also be variety of other problems including bone lesions, pneumonitis etc.
In most cases, there is neural involvement - lethargy, irritability, motor tone problems, mental retardation, motor disabilities, abnormal posture, neurosensory hearing loss.
Varicella infection in pregnant women can cause severe chickenpox with increased risks of varicella pneumonia.
The fetus is at risk of Congenital Varicella Syndrome (CVS) if infection occurs in the first 20 weeks of pregnancy (risk 1-2%). CVS can cause a range of problems including limb shortening, skin scarring, cataracts and growth retardation.
Infection with varicella in the later stages of pregnancy can cause premature delivery or neonatal chickenpox infection. This is particularly serious if the mother becomes infected 7 days before birth. For these reasons, pregnant women exposed to VZV are offered IgG testing and the neonates are given immunoglobulin to help fight the infection.
No comments:
Post a Comment