Management strategies for infectious diseases in pregnancy.
This review presented the clinical manifestations, diagnostic and therapeutic options, and preventive strategies for several congenital infections. The infections discussed show the spectrum of modes of vertical transmission and severity of fetal disease encountered, in addition to the successes and limitations of the current medical interventions. Further improvements in diagnostic techniques and therapies for managing the infected fetus are likely to occur during the next decade. Similarly, the widespread adaptation of new and sensitive diagnostic assays, such as the polymerase chain reaction, is likely to further improve our ability to identify infectious agents as the primary cause of certain abnormal fetal conditions. Where specific diagnostic tests and therapies have proven successful in preventing or treating fetal infections, universal screening programs should be given serious consideration. Of paramount importance, however, is the active research on the development of preventive interventions designed to prevent maternal infections and vertical transmission. Although specific immunotherapies, vaccines, and drug therapies hold great promise for controlling the spread of some infections, it cannot be overemphasized that some serious infectious complications of pregnancy may be avoided by simple preconception or early antenatal maternal counseling.
Guerina
N G
NG
Department of Obstetrics, New England Medical Center, Boston, MA 02111.
D000163:Acquired Immunodeficiency Syndrome / Q000151:congenital / Q000517:prevention & control / Q000635:transmission; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy / Q000635:transmission; D016731:Erythema Infectiosum / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000628:therapy; D011296:Prenatal Diagnosis; D014123:Toxoplasmosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014125:Toxoplasmosis, Congenital