Parvovirus 细小病毒


Diagnostic points 

诊断要点


Exposure to an infected individual is associated with a 50% risk of maternal infection and 17% to 33% risk of fetal infection. If exposed, a pregnant woman should have IgG and IgM screening. If the anti-parvovirus IgM titer is positive, the woman is presumed to be infected and fetal infection is possible. 

与感染原接触的母体，有50％的感染风险，其胎儿的感染率为17％~33％。对于有感染原接触史的孕妇，应行IgG和IgM筛查。如果抗细小病毒IgM滴度为阳性，则可被认为受感染，其胎儿也有可能被感染。


The fetus of a woman with confirmed new parvovirus infection based on positive IgM should have be monitored for fetal anemia with serial ultrasounds to evaluate for presence of hydrops and placentamegaly, and Doppler interrogation of the middle cerebral artery (MCA) for peak systolic velocity. Elevated MCA Doppler is concerning for fetal anemia. MCA Doppler studies should be performed every 1 to 2 weeks for up to 12 weeks after maternal infection.

基于IgM阳性确诊新感染细小病毒的孕妇的胎儿，应该行系列超声检查评估胎儿贫血情况，胎儿水肿情况，以及大脑中动脉（MCA）的收缩期峰值速度。MCA升高提示胎儿贫血。感染的孕妇应该每1~2周行MCA多普勒检查，直至孕12周。


New points 

新的亮点


1. Fetuses who had hydrops due to maternal parvovirus infection and required in utero transfusion may have an increase in neurodevelopmental impairment. 因孕期感染细小病毒导致的水肿胎儿，需要宫内输血的，可能增加神经发育缺陷的风险。


2. Routine screening of pregnant women for parvovirus IgM should not be performed.

不推荐执行孕妇细小病毒IgM抗体的常规筛查。


Level A Recommendation 

A级推荐


Pregnant women with acute parvovirus infection should be evaluated for fetal anemia with serial ultrasound studies, including Doppler assessment of peak systolic velocity of the fetal MCA.

急性细小病毒感染的孕妇，应行系列超声检查评估胎儿贫血，包括胎儿MCA的收缩期峰值速度的多普勒评估。