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中华产科急救电子杂志 ›› 2020, Vol. 09 ›› Issue (04) : 199 -203. doi: 10.3877/cma.j.issn.2095-3259.2020.04.003

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妊娠期巨细胞病毒感染的诊断、处理和咨询策略
冯静1, 周乙华1,()   
  1. 1. 210008 南京大学医学院附属鼓楼医院妇产科
  • 收稿日期:2020-05-07 出版日期:2020-11-18
  • 通信作者: 周乙华

Diagnosis, management and counseling of cytomegalovirus infection during pregnancy

Jing Feng1, Yihua Zhou1()   

  • Received:2020-05-07 Published:2020-11-18
  • Corresponding author: Yihua Zhou
引用本文:

冯静, 周乙华. 妊娠期巨细胞病毒感染的诊断、处理和咨询策略[J/OL]. 中华产科急救电子杂志, 2020, 09(04): 199-203.

Jing Feng, Yihua Zhou. Diagnosis, management and counseling of cytomegalovirus infection during pregnancy[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2020, 09(04): 199-203.

本文描述了妊娠期不同类型巨细胞病毒(cytomegalovirus,CMV)感染的宫内感染发生率,如何鉴别活动性感染的类型以及如何诊断胎儿发生宫内感染的策略。明确指出妊娠期CMV活动性感染时,需结合胎儿是否感染和胎儿影像学检查结果为患者提供咨询,不能仅因为孕妇CMV IgM和IgG阳性而终止妊娠,还应鼓励母乳喂养。

This review article provides the information on the incidence of intrauterine transmission in various types of maternally active cytomegalovirus (CMV) infection, the differentiation of active CMV in pregnant women, and the diagnosis of fetal CMV infection. This document clearly states that the prenatal counseling should be based on the combination of the status of fetal CMV infection and the results of fetal imaging. It is emphasized that the pregnancy should not be terminated only based on the maternal positive for CMV IgM and IgG. Detection of CMV DNA in breastmilk is not required and breastmilk beefing should be encouraged.

图1 孕期不同CMV感染类型宫内感染发生率及其对胎儿的影响
表1 孕妇CMV IgM和IgG检测结果判读
图2 母体不同感染类型宫内感染诊断流程
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