ABSTRACT
A total of 300 pregnant women were screened for the presence of human parvovirus B19 IgG and IgM antibodies by an enzyme-linked immunosorbent assay (ELISA). Overall, 253 (84.3 percent) were found to be IgG-positive and IgM-negative (IgG+IgM-), 42 (14 percent) had neither IgG nor IgM antibodies (IgG-/IgM-) and 5 (1.7 percent) were both IgM- and IgG-positive (IgG+/IgM+). Maternal serology was performed routinely for cytomegalovirus, rubella, toxoplasmosis and syphilis. All IgG-/IgM- and IgG+/IgM+ women were followed until the time delivery, with venous blood samples taken monthly from each, one IgG-/IgM- mother seroconverted to IgG+/IgM- and B19 DNA was detected by nested polymerase chain reaction technique (PCR) in her serum. All babies born to IgG+/IgM+ mothers (and from the one who seroconverted) were IgG+IgM-, but no B19 DNA could be detected in their sera and no adverse effects were documented either by ultrasonographic examination or by detection of maternal serum alpha-fetoprotein. While 5 of the mothers delivered normal children at term, one gave birth to a premature (low-weight) baby who developed severe anemia and had convulsions. However, this mother was found to have toxoplasma-specif IgM. Our data indicate a low frequency of B19 infection in pregnancy in our region, at least during interepidemic periods. This appears to be partly due to high prevalence of prior infection among pregnant women. Recent B19 infection in 6 women did not lead to adverse fetal outcomes. This observation, however, in a small number of serologically positive patients, does not contradict the observations by others that recent infection does converg a risk for the fetus.
Subject(s)
Humans , Female , Pregnancy , Cohort Studies , Parvoviridae Infections/diagnosis , Parvoviridae Infections/transmission , Infectious Disease Transmission, Vertical , Parvovirus B19, Human , Pregnancy Complications, Infectious , Enzyme-Linked Immunosorbent Assay , Erythema Infectiosum/complications , Hydrops Fetalis/complications , Infant, Very Low Birth Weight , Maternal-Child Health Centers , Polymerase Chain Reaction , Prenatal CareABSTRACT
Alteracoes morfologicas e funcionais do intestino delgadotem sido descrita em criancas que vivem em ambientes desfavoraveis, mesmo naquelas assintomaticas. Nete trabalho analisamos a ultra-estrutura da mucosa jejunal de criancas portadoras de enteropatia ambiental assintomatica. Omaterial de biopsia do intestino delgado estruturado foi procedente de 28 criancas, de ambos os sexos, com 2 a 12 meses de idade, e sem manifestacao gastrointestinal, portadoras de enteropatia ambiental assintomatica. A observacao ultra-estrutural foi realizada em um microscopio eletronico LM-9 Zeiss e alteracoes de intensidade variavel foram observadas em 19 (67,8//) pacientes: alteracoes das microvilosidades, tais como encurtamento, alargamento, fusao, formacao de tufos, reducao do numero emesmo ausencia das mesmas, foram observadas em 12 (63,1//); aumento do numero de lisossomos e corpos multivesiculares foram encontrados em 6 (31,5//) e 5 (26,3//) pacientes, respectivamente. As alteracoes ultra-estruturais observadas nestas criancas assintomaticas podem resultar no comprometimento da funcao digestivo-absortiva, muito provavelmente como decorrencia das altas taxas de contaminacao ambiental