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Prognosemodelle für intrauterine Infektionen anhand des Zytomegalievirus (CMV)

Prognosis of primary cytomegalovirus (CMV) infection in pregnancy

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Der Gynäkologe Aims and scope

Zusammenfassung

Die vorgeburtliche Primär-Infektion mit dem Zytomegalievirus gehört zu den relevantesten Infektionen in der Schwangerschaft. Sie kann zu einer erheblichen Entwicklungsstörung des Kindes führen, kann aber auch folgenlos bleiben. Für die Risikobeurteilung ist der Zeitpunkt der mütterlichen Infektion und konsekutiv die Wahrscheinlichkeit der maternofetalen Transmission zur zentraler Bedeutung. Mit zunehmender Schwangerschaftswoche steigt die Transmissionshäufigkeit, gleichzeitig sinkt aber die Wahrscheinlichkeit einer fetalen Schädigung. Therapeutische Ansätze beinhalten die Prävention der mütterlichen Infektion durch Hygienemaßnahme, die Prävention der Transmission durch Hyperimmunglobulin und die Therapie des Feten mit Valaciclovir.

Abstract

Prenatal primary infections with the cytomegalovirus is one of the most relevant infections in pregnancy. It can lead to a considerable developmental disorder of the child but can also be without consequences. The time of maternal infection and, subsequently, the probability of maternal-fetal transmission are of crucial importance for risk assessment. The frequency of transmission increases with increasing gestational age; however, at the same time the probability of fetal and postnatal sequelae decreases. Therapeutic approaches include prevention of maternal infection through hygiene measures, prevention of transmission through hyperimmunoglobulin and treatment of the fetus with valacyclovir.

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Authors and Affiliations

  1. Department für Frauengesundheit, Universitätsklinikum Tübingen, Calwerstr. 7, 72076, Tübingen, Deutschland

    Karl Oliver Kagan & Markus Hoopmann

  2. Institut für Medizinische Virologie und Epidemiologie von Viruserkrankungen, Universitätsklinikum Tübingen, Tübingen, Deutschland

    Klaus Hamprecht

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  1. Karl Oliver Kagan
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Correspondence to Karl Oliver Kagan.

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Interessenkonflikt

K. O. Kagan, K. Hamprecht und M. Hoopmann weisen auf folgende Beziehungen hin: K. O. Kagan und K. Hamprecht haben für Biotest, ein Unternehmen, das Immunglobuline herstellt, bezahlte Vorträge gehalten. K. Hamprecht ist Mitglied des Wissenschaftlichen Beirats der Initiative zur Prävention von angeborenen Zytomegalie-Erkrankungen (ICON - Initiative for the Prevention of Congenital Cytomegaly Disorders). Alle damit verbundenen Honorare werden auf ein Stipendienkonto des UKT-Instituts für medizinische Virologie eingezahlt, um die Tübinger Studie über angeborene CMV zu unterstützen. Alle drei Autoren führen Studien zur Effektivität der Hyperimmunglobulintherapie durch.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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R. Zimmermann, Zürich

K. Vetter, Berlin

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Kagan, K.O., Hamprecht, K. & Hoopmann, M. Prognosemodelle für intrauterine Infektionen anhand des Zytomegalievirus (CMV). Gynäkologe 53, 813–820 (2020). https://doi.org/10.1007/s00129-020-04706-z

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  • DOI: https://doi.org/10.1007/s00129-020-04706-z

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