Parvovirus-B 19-Infektion in der Schwangerschaft

I. Mylonas; S. Gutsche; G. Anton; U. Jeschke; E.-R. Weissenbacher; K. Friese

doi:10.1055/s-2006-921504

Zeitschrift für Geburtshilfe und Neonatologie, Inhaltsverzeichnis

Z Geburtshilfe Neonatol 2007; 211(2): 60-68
DOI: 10.1055/s-2006-921504

Übersicht

Parvovirus-B 19-Infektion in der Schwangerschaft

Parvovirus B 19 Infection During PregnancyI. Mylonas¹ ^, ² , S. Gutsche¹ , G. Anton² , U. Jeschke¹ ^, ² , E.-R. Weissenbacher² , K. Friese¹ ^, ²

¹1. Frauenklinik München - Klinikum Innenstadt
²Frauen- und Poliklinik - Klinikum Großhadern

Abstract

Zusammenfassung

Das humanpathogene Parvovirus B 19 gehört zur Familie der Parvoviridae und weist einen ausgeprägten Tropismus für die erythropoiden Vorläuferzellen auf. Bei Kindern verursacht das Virus das Erythema infectiosum (Ringelröteln). Inzwischen wird die Parvovirus-B 19-Infektion mit einem weiten Spektrum von hämatologischen und nichthämatologischen Komplikationen in Zusammenhang gebracht (z. B. Leberversagen, Hepatitis, aplastische Krisen vor allem mit chronischen hämolytischen Anämien, chronische Arthritis, Arthralgien / Arthritis, transiente / persistierende Anämien, Vaskulitis, Glomerulonephritiden). Intrauterine Infektionen können bei Überleben des Fetus zu spezifischen oder permanenten Organdefekten führen (z. B. Herzanomalien, Augenerkrankungen, Lippen-Kiefer-Gaumenspalte, Mikrognathie, chronische Anämie, Myokarditis, Hepatitis, Mekoniumperitonitis und ZNS-Anomalien). Parvovirus B 19 konnte mit einem Hydrops fetalis und intrauterinem Fruchttod bei Infektionen in der Schwangerschaft assoziiert werden. Ein sicherer Zusammenhang zwischen Missbildung und B 19-Infektion ist noch nicht gewährleistet. Zum weiteren Ausschluss von teratogenen Effekten und fetalen Schäden sollte der Ausgang von B 19-infizierten Schwangerschaften überwacht und kontrolliert werden. Obwohl kongenitale Malformationen nach Parvovirusinfektion berichtet worden sind, scheint dies allerdings ein seltenes Phänomen zu sein. Eine intrauterine Therapie mit Erythrozytenkonzentrat könnte bei Hydrops fetalis und erniedrigten Hämoglobinwerten durchgeführt werden. Untersuchungen zur Entwicklung und klinischen Testung eines effizienten Impfstoffes gegen Parvovirus B 19 sind zzt. in Vorbereitung.

Abstract

The parvovirus B 19 is part of the family of the parvoviridae and shows a distinctive tropism for erythropoid precursor cells. The virus causes in children the erythema infectiosum (German measles). Meanwhile, parvovirus B 19 infections can be associated with a wide spectrum of hematological and non-hematological complications (e. g. liver failure, hepatitis, aplastic crises primarily in association with chronic hemolytic anaemias, chronic arthritis, arthralgia / arthritis, transient / persistent anaemias, vaskulitis, glomerulonephritis). Intrauterine infections can lead to specific or permanent organ defects (e. g. heart anomalies, eye diseases, micrognathy, chronic anaemia, myocarditis, hepatitis, mekonium peritonitis and central nervous system anomalies). Parvovirus B 19 infections are also associated with hydrops fetalis and intrauterine death during pregnancy. A definite relation between fetal malformations and B 19 infection has not been accomplished yet. Pregnancies complicated by parvovirus B 19 infection should be followed for further exclusion of any teratogenic effect. Although congenital malformations after a parvovirus infection are possible, this phenomenon seems to be rare. An intrauterine therapy with packed red cells could be performed for hydrops fetalis and low haemoglobin concentration. Investigation for the development and clinical testing of an efficient vaccine against parvovirus B 19 is currently in progress.

Schlüsselwörter

Parvovirus - fetale Schädigung - kongenitale Anomalien - Diagnose - Therapie

Key words

parvovirus - fetal malformation - congenital anomalies - diagnosis - therapy

Volltext

Referenzen

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Dr. med. I. Mylonas
Prof. Dr. med. habil. K. Friese

1. Frauenklinik München - Klinikum Innenstadt · Ludwig Maximilians Universität München

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