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成人感染细小病毒通常无症状而常被忽视,而孕期宫内细小病毒感染伴有母血AFP升高者,预示胎儿预后很差。作者报告一例33岁初产妇,一月前因短暂嗜睡、发热和关节痛及孕17周时母血浆AFP升高(100IU,MoM 3.86)就诊。绒毛取样及羊膜腔穿刺胎儿核型正常,羊水AFP正常,乙酰胆碱酯酶凝胶试验阴性,超声波示胎儿腹水、肝肿大、心脏增大及少许心包积液,未见结构缺损,母血清学检查弓形体、柯萨奇B病毒、巨细胞病毒、风疹病毒均阴性,大便培养(包括李斯特菌属)阴性,细小病毒B_(19)IgM检查为50AU(任意单位)。于孕18周用前列腺素阴道药栓引产终止妊娠,为男性死婴,水肿,顶臀长17cm,体重299g,心肝高度自溶,腭为高拱形,唇很小,两小手指及双侧第一、二趾
Infectious parvovirus in adults is usually asymptomatic and often overlooked, whereas intrauterine parvovirus infection during pregnancy is associated with elevated AFP in maternal blood, indicating a poor fetal prognosis. The authors report a 33-year-old primiparous woman who was diagnosed with maternal plasma AFP elevation (100 IU, MoM 3.86) one month ago due to a brief drowsiness, fever and arthralgia and 17 weeks gestation. Fluff sampling and amniocentesis fetal normal karyotype, normal amniotic fluid AFP, acetylcholinesterase gel test was negative, ultrasound showed fetal ascites, hepatomegaly, cardiac enlargement and a little pericardial effusion, no structural defects, maternal serum tests Toxoplasma, Coxsackie B virus, cytomegalovirus, rubella virus were negative, stool culture (including Listeria) negative, parvovirus B_ (19) IgM examination of 50AU (any unit). Pregnancy 18 weeks with prostaglandin vaginal suppository abortion termination of pregnancy for male dead baby, edema, top hip length 17cm, weight 299g, high autolysis of the heart and liver, the palate is a high arch, the lip is very small, two little fingers and bilateral One, two toe