Viral Diseases in Pregnancy

284 Pages·1994·9.897 MB·English

by  Eyal Y. Anteby, Simcha Yagel (auth.), Bernard Gonik M.D. (eds.)

Cp Clinical Perspectives in Obstetrics and Gynecology
OB/GYN
Series Editor:
Isaac Schiff, M.D.
Clinical Perspectives in Obstetrics and Gynecology
-CP
OB/GYN
Series Editor: Isaac Schiff, M.D.
Published Volumes:
Shoupe and Haseltine (eds.): Contraception (1993)
Lorrain (ed.): Comprehensive Management of
Menopause (1993)
Gonik (ed.): Viral Diseases in Pregnancy (1994)
Forthcoming Volumes:
Framm and Quilligan (eds.): Cesarean Section:
Guidelines for Appropriate Utilization
Reindollar: Molecular Biology for the
Obstetrician-Gynecologist
Published Volumes (Series Editor: The Late
Herbert J. Buchsbaum, M.D.):
Buchsbaum (ed.): The Menopause (1983)
Aiman (ed.): Infertility (1984)
Futterweit: Polycystic Ovarian Disease (1984)
Lavery and Sanfilippo (eds.): Pediatric and Adolescent
Obstetrics and Gynecology (1985)
Galask and Larson (eds.): Infectious Diseases in the
Female Patient (1986)
Buchsbaum and Walton (eds.): Strategies in Gynecologic
Surgery (1986)
Szulman and Buchsbaum (eds.): Gestational Trophoblastic
Disease (1987)
Cibils (ed.): Surgical Diseases in Pregnancy (1990)
Collins (ed.): Ovulation Induction (1990)
Sanfilippo and Levine (eds.): Operative Gynecologic
Endoscopy (1990)
Altchek and Deligdisch (eds.): The Uterus (1991)
Viral Diseases
in Pregnancy
Bernard Gonik
Editor
With 31 Illustrations and 12 Color Plates
Springer-Verlag
New York Berlin Heidelberg London Paris
Tokyo Hong Kong Barcelona Budapest
Editor:
Bernard Gonik, M.D.
Professor and Vice Chairman
Department of Obstetrics and Gynecology
Wayne State University School of Medicine
Chief of Obstetrics and Gynecology-Grace Hospital
6071 West Outer Drive
Detroit, MI 48235, USA
Library of Congress Cataloging· in· Publication Data
Viral diseases in pregnancy / [edited by] Bernard Gonik.
p. cm.-(Clinical perspectives in obstetrics·gynecology)
Includes bibliographical references and index.
ISBN-13: 978-1-4612-7620-3
1. Virus diseases in pregnancy. I. Gonik, Bernard. II. Series:
Clinical perspectives in obstetrics and gynecology.
[DNLM: 1. Virus Diseases-in pregnancy. WC 500 V81251994]
RG580.V5V54 1994
618.3-dc20
DNLM/DLC
for Library of Congress 93-38947
Printed on acid-free paper.
© 1994 Springer·Verlag New York, Inc.
Softcover reprint of the hardcover 1s t edition 1994
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ISBN-I 3:978-1-4612-7620-3 e-ISBN-13: 978-1-4612-2640-6
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This textbook is dedicated to llana, Nathan, Daniel, and
Cookie for their constant support and understanding. Also, to
my many mentors and colleagues who, through their scientific
and clinical endeavors, set the highest of standards for us to
emulate. Lastly, to the women of the world; they bear our
children, rear our young, and through their eyes we must
all be judged.
Preface
The pregnant host is at risk for any of the viral diseases her
nonpregnant counterpart acquires. Additionally, pregnancy
heightens our concerns regarding specific viral diseases be
cause of their potential for enhanced adverse effects on both
maternal and fetal well-being. All too often the obstetrician
relinquishes responsibility for the management of the gravida
infected by a viral pathogen, and those expert in infectious
diseases are confounded by the influence of pregnancy on these
conditions. A major goal of this textbook is to narrow the gap
between the two aforementioned management dichotomies in
the virally infected pregnant woman.
Weare at the infancy of our understanding of viral infections
in pregnancy. The current and anticipated advancements are
due in large part to a burgeoning oftechnological achievements
in the areas of immunodiagnostics, molecular biology, and
pharmacotherapeutics. Our in utero diagnostic capabilities,
both invasive and noninvasive, have also allowed us new
opportunities to study the effects of various maternal infectious
disease processes on the developing fetus. New insights have
been recognized pertaining to the maternal-fetal interface, the
placenta, in that this structure is now acknowledged to function
as both a mechanical and an immunological barrier to vertical
transmission of infection. These observations suggest that
there will be an outpouring of new data in the next several years
that clinicians will need to master to maintain an appropriate
level of expertise in the care of their patients.
This infectious disease textbook is the first in many years to
address specifically the topic of viral disease in pregnancy.
Topics were selected on the basis of their importance to
obstetrics and the fact that new information was available for
dissemination to the clinical community. The contributing
authors were chosen for their recognized expertise, and have
provided the readership with scientifically complete yet clini
cally relevant chapters. A color section, highlighting specific
derma to logic or diagnostic features of certain viral diseases,
VB
VIll Preface
is included because many of these conditions first come to the
attention of the caring physician as a result of clinical manifes
tations of the disease. Although not all of these examples were
obtained from pregnant women, they were the most representa
tive illustrations available. An attempt was made, when possi
ble, to follow a designated format for the chapters to maintain
a sense of uniformity. Authors were asked to include sufficient
information so that patient counseling and management deci
sions could be extrapolated from appropriate chapters. At
times, authors differed in their approach to specific viral dis
eases in pregnancy. Some chapters, therefore, present dispa
rate opinions, reflecting the dynamics of this field of study.
It is hoped that our efforts in the writing, editing, and
production of this work have culminated in a useful reference
text for a wide variety of health care providers. Omissions
or inaccuracies are in part the responsibility of the editor, and
I therefore look forward to comments from interested individ
uals in the event these are identified. This will allow for
improvements in the quality ofthis and other texts in the future.
I acknowledge Margaret Butler for her assistance in the
preparation of these materials and the staff at Springer-Verlag
for their commitment to quality work.
Bernard Gonik
Contents
Preface ........................................ Vll
Contributors ............... .................. ... Xl
1 Immune Responses to Viral Infection 1
EYAL Y. ANTEBY AND SIMCHA YAGEL
2 Viral Teratology 12
JAN E. DICKINSON
3 In Utero Diagnosis of Congenital Infection 24
NELSON B. ISADA AND STANLEY M. BERRY
4 Genital Herpes Simplex Virus ................... 50
PAUL A. HENSLEIGH AND LILY K. NGUYEN
5 Cytomegalovirus 69
GAIL J. DEMMLER
6 Varicella-Zoster Virus 92
LAURA E. RILEY
7 Epstein-Barr Virus ............................ 106
KENNETH F. TROFATTER, JR.
8 Human Immunodeficiency Virus 128
PAMELA STRATTON
9 Hepatitis Viruses 156
NEIL S. SILVERMAN
10 Human Papillomavirus ........................ 185
BRUCE PATSNER, DAVID A. BAKER, AND EARL JACKMAN
11 Parvovirus ............ "...................... 196
JOHN F. Roms AND ANTHONY M. VINTZILEOS
IX
x Contents
12 Influenza Virus ............................... 215
SHAMSA Z. SHAHAB AND W. PAUL GLEZEN
13 Enterovirus .................................. 224
PAUL R. SUMMERS AND HOWARD T. SHARP
14 Mumps, Measles, Rubella, and Roseola ........... 236
BRYAN T. OSHIRO, MANJU MONGA, AND JACK M. GRAHAM
15 Molluscum Contagiosum ....................... 248
RAN GOSHEN AND BERNARD GONIK
16 Immunization During Pregnancy ................ 253
BERNARD GONIK
Index .......................................... 263
Contributors
EYAL Y. ANTEBY, M.D.
Department of Obstetrics and Gynecology, Hebrew University
Hadassah Hospital, Mt. Scopus, Jerusalem, 91240 Israel
DAVID A. BAKER, M.D.
Department of Obstetrics and Gynecology, Division of Infec
tious Disease, State University of New York at Stony Brook,
Stony Brook, NY 11794-8091, USA
STANLEY M. BERRY, M.D.
Department of Obstetrics and Gynecology, Division of Mater
nal and Fetal Medicine, Wayne State University, Hutzel Hospi
tal, Detroit, MI 48201, USA
GAIL J. DEMMLER, M.D.
Department of Pediatrics, Infectious Diseases Section, Texas
Children's Hospital, Clinical Care Center, Houston, TX 77030-
2399, USA
JAN E. DICKINSON, F.R.A.C.O.G.
Department of Obstetrics, King Edward Memorial Hospital for
Women, Subiaco, Western Australia 6008, Australia
W. PAUL GLEZEN, M.D.
Department of Microbiology and Immunology, Preventive Med
icine Section, Baylor College of Medicine, Houston, TX 77030,
USA
BERNARD GONIK, M.D.
Department of Obstetrics and Gynecology, Wayne State Uni
versity School of Medicine, Detroit, MI 48235, USA
RAN GOSHEN, M.D.
Department of Obstetrics and Gynecology, Hebrew University
Hadassah Hospital, Mt. Scopus, Jerusalem, 91240 Israel
JACK M. GRAHAM, M.D.
Department of Obstetrics and Gynecology, Baylor University
Medical Center, Dallas, TX 75246, USA
Xl