Pränatale und perinatale Virusinfektionen aus gynäkologisch-geburtshilflicher Sicht*

Abstract

Virus infections in pregnancy cause a varying risk of embryopathy or fetopathy according to the type of causative virus. The spectrum encompasses the high prenatal risk of rubella or cytomegaly and perinatally, also hepatitis B to the low or absent risk of mumps, measles, or hepatitis A. If all preventive and diagnostic measures are observed prenatal rubella infection can today be prevented. All women in the reproductive age group require testing of the rubella titre or rubella immunization. Cytomegaly in pregnancy can neither be diagnosed nor prevented. This is very unfortunate since the incidence of prenatal or perinatal damage to the fetus by cytomegaly is estimated to be 1:1000 births. More attention needs to be payed to herpes simplex type II infections during pregnancy because of its increasing frequency especially in young promiscuous mothers and because of the improved diagnosis by vaginal cytology and the improved treatment by new antiviral agents. Whereas hepatitis A poses no risk to the fetus, there is a risk of infection of the infant in cases of hepatitis B especially when the mother is perinatally HBsAg and HBeAg positive. In these cases the newborn requires preventive treatment with hepatitis B specific hyperimmunoglobulin. In HBsAg-positive mothers without e-Antigen hyperimmunoglobulin treatment of the newborn is also recommended as prophylaxis. This prophylaxis reduces the infection rate of the newborn, prevents serious manifestations of infection and prevents persistence of the virus. Prevention of infection of the newborn has recently been further improved by concomitant active immunization for hepatitis B. Isolation techniques and special considerations for the conduct of labour in HBsAg-positive mothers are mentioned.(ABSTRACT TRUNCATED AT 250 WORDS)