Disease >> Obstetrics and Gynecology >> Gynecology

Cytomegalovirus infection in pregnancy

Introduction
Cause
Prevention
Complication
Symptom
Examine
Diagnosis

Introduction

Introduction to pregnancy with cytomegalovirus infection Cytomegalovirus infection is the most common cause of congenital infections, causing serious damage to the fetus, infants, and even death. Of particular importance is the sequela of the central nervous system. Due to changes in the immune mechanism and endocrine environment during pregnancy, the relationship between the host cell and the virus can be changed, and the latent virus can be reactivated. 1% to 5% of pregnant women with primary infection develop mononucleosis, hepatitis and interstitial pneumonia. Neonatal congenital cytomegalovirus infection accounts for 0.5% to 2.5% of all newborns, of which 15% to 33% of clinical manifestations are abnormal, and 10% suffer permanent damage. Chinese medicine believes that this disease is mostly caused by hepatobiliary dampness and heat, which is blocked by the genitals. basic knowledge Proportion of disease: 1-3% of the total number of pregnant women Susceptible population: pregnant women and newborns Mode of transmission: sexual transmission mother-to-child transmission Complications: abortion, jaundice, mental retardation

Cause

Pregnancy with cytomegalovirus infection

Virus infection (39%):

Cytomegalovirus infection is a systemic infectious disease caused by cytomegalovirus (CMV), which has been classified as a sexually transmitted disease in recent years. The characteristic cancer of cytomegalovirus infection becomes an increase in infected cells, and eosinophilic and alkalophilic inclusion bodies appear in the nucleus and cytoplasm, respectively. Cytomegalovirus has the biological characteristics of latent activity, mostly latent infection, which can be activated by pregnancy.

Prevention

Pregnancy with cytomegalovirus infection prevention

To avoid infection, early detection of cytomegalovirus infection in pregnant women, or immediate abortion to terminate the pregnancy, or wait until the 20th week of pregnancy to take amniotic fluid or umbilical vein blood to check for specific IgM, if it is positive should interrupt pregnancy for induction of labor, In order to avoid birth defects. Since there may be CMV in the urine of newborns, disposable diapers should be used to disinfect the used diapers.

Pregnant women are mainly infected by oral and sexual life, so cytomegalovirus infection is also a type of sexually transmitted diseases. Another important route of transmission is the exposure of pregnant women to the urine and saliva of sick children. Therefore, careful washing of pregnant women is also an important measure to avoid illness.

Complication

Complications of pregnancy with cytomegalovirus infection Complications, abortion, jaundice, mental retardation

Abortion, stillbirth, stillbirth, and neonatal death can occur. If surviving, about 10% of newborns have low body weight, jaundice, cyanosis, hepatosplenomegaly, mental retardation, retinal choroiditis, intracerebral calcification, and microcephaly. Most children die within hours to weeks after birth. Survivors often have long-term sequelae of mental retardation, hearing loss, and delayed central nervous system damage.

Symptom

Pregnancy with cytomegalovirus infection symptoms Common symptoms Increased vaginal discharge fatigue neck lymph node enlargement low heat joint pain sore throat

The cytomegalovirus infection of pregnant women during pregnancy is mostly a recessive infection. There are no obvious symptoms and signs. It can be in a state of being infected for a long time. The cytomegalovirus can be discharged through saliva, urine, milk and cervical secretions. A small number of low fever, fatigue, headache, sore throat, muscle and joint pain, increased vaginal discharge, cervical lymphadenopathy, multiple neuritis. If it is a primary cytomegalovirus infection, the incidence of congenital abnormalities in the fetus is high and the condition is serious.

Examine

Examination of pregnancy with cytomegalovirus infection

Because of the lack of specificity in clinical presentation, diagnosis depends on pathogenic and serological diagnosis.

Common methods are:

(1) Enzyme-linked immunosorbent assay for detecting serum cytomegalovirus IgG and IgM in pregnant women;

(2) After the Giemsa staining of cervical exfoliated cells or urine smears of pregnant women, the eosinophilic or basophilic particles in the nucleus of exfoliated cells were detected under light microscope, and giant cell inclusion bodies were seen. This specific cell is called owl eye cells and has Diagnostic value;

(3) DNA hybridization technology for detection of cytomegalovirus DNA, which is simple, rapid and sensitive;

(4) PCR technology was used to amplify cytomegalovirus DNA, and satisfactory results were obtained in a short time. There are data showing that the cytomegalovirus infection rate of pregnant women in China is 8.82%, the positive rate of neonatal umbilical serum cytomegalovirus IgM is 2.32%; the positive rate of DNA multi-cell cytomegalovirus DNA in pregnant women is 8.7%, breast milk giant cells The positive rate of viral DNA was 10.26%. Diagnosis of congenital cytomegalovirus infection, except for the history of infection with cytomegalovirus in pregnant women and the clinical manifestations of children. It is mainly diagnosed based on the results of laboratory tests. In the case of intrauterine infection, cytomegalovirus inclusion bodies can be detected from neonatal urine or cerebrospinal fluid at birth, or cytomegalovirus IgM can be detected from cord blood or neonatal blood, which has diagnostic value. In the case of a birth canal infection, cytomegalovirus inclusion bodies can be detected from the neonatal urine at least 2 weeks after birth. In addition, neonatal urine, gastric eluate, cerebrospinal fluid sediment for smear and staining, under the light microscope to find a large cell containing typical eosinophilic nuclear inclusions, also has diagnostic value.

Diagnosis

Diagnosis and diagnosis of pregnancy complicated with cytomegalovirus infection

diagnosis