孕期弓形体感染对胎、婴儿的影响及治疗

目的：研究孕期弓形体感染胎、婴儿的结局，母婴传播途径及治疗。方法：应用ＥＬＩＳＡＩｇＭ方法筛查３８７８例孕妇弓形体近期感染情况。追踪８２例弓形体近期感染孕妇分娩的胎、婴儿预后、收集脐血、羊水、胎盘及尸解的器官组织了解母婴传播途径及病理改变。观察应用螺旋霉素系统治疗孕期弓形体感染者的胎、婴儿预后，并与未治疗组对照。结果：本组孕妇弓形体近期感染发生率为４．４１％（１７１／３８７８），其胎、婴儿出现临床症状为３０．４８％（２５／８２）；孕早期感染以畸胎、流产多见，孕晚期感染表现为早产、低体重儿、黄疸及弓形体感染性肺炎等。从胎盘、羊水、脐血及尸解器官组织中可查出弓形体ＤＮＡ。显示弓形体可通过胎盘感染胎儿，严重者造成器官损害。应用螺旋霉素治疗孕期弓形体感染有效。治疗组先天性弓形体感染发生率低于对照组（Ｐ＜０．０１）。结论：孕妇近期弓形体感染可通过胎盘感染胎儿，造成畸胎、流产、早产、低体重儿及急性弓形体感染症状。螺旋霉素治疗孕期弓形体感染有效。

Influences of the transmisson of toxoplasma from mother to fetus during pregnant period and its intrauterine therapy.

Objective To investigate the influences of the transmission of toxoplasma from mother to fetus during pregnant period and its therapy as well as its outcome. Methods Using the enzyme linked immunosorbent assay(ELISA) IgM,3878 pregnant women were screened for toxoplasma infection.The umbillical blood,amniotic fluid and placenta were detected by PCR method to know whether there were toxoplasma infected or not.All fetuses with malformations had been autopsied by pathological method.The intrauterine therapeutic effects of spiromycin were observed and controlled with those cases without therapy.Results Among 3878 pregnant women,171 cases were suffered from toxoplasma with an infecting rate of 4.41 %,and those fetuses appearing clinical sign was 30.48%(25/32) with bad prognosis.There were more malformations and abortions in the early and midterm of pregnancy,while in the late pregnancy only the symptoms of the toxoplasma affected neonatus.The DNA of toxoplasma could be detected in the umbillical blood,amniotic fluid,placenta,and fetuses tissuses of organs in autopsy. Conclusion Toxoplasmosis can be through placenta to fetus and makes fetus to be injuried.After treatment with spiromycin in toxoplasma infected mother,the incidence of the congenital toxoplasmosis is lower than that in non terapy group( P <0.01)