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Ringelröteln

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S2k-Leitlinie - Labordiagnostik schwangerschaftsrelevanter Virusinfektionen

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Zusammenfassung

Parvovirus B19-Infektionen sind weltweit verbreitet. Die Viren werden überwiegend durch Aerosole übertragen, sie verursachen die Ringelröteln (Erythema infectiosum), in deren Verlauf sich eine transiente Anämie ausbildet. Akute Parvovirus B19-Infektionen treten gehäuft bei Kindern im Vorschulalter, etwa 70-80 % der Erwachsenen sind seropositiv. Es existiert keine Impfung zur Prävention der Infektion. Werden Schwangere innerhalb der ersten 20 SSW infiziert, so kann die Infektion Aborte oder – bedingt durch die Infektion des Feten - einen Hydrops fetalis verursachen. Dieses Erkrankungsbild tritt im Feten mit einer Verzögerung von einigen Wochen zur Infektion der Schwangeren auf und wird durch die infektionsbedingte Anämie verursacht, die durch Zerstörung der fetalen Erythrozytenvorläuferzellen entsteht. Bei Schwangeren mit beruflichen und/oder familiären Kontakten zu unter sechsjährigen Kindern wird in der Frühschwangerschaft die Überprüfung des Serostatus empfohlen, ebenso bei Schwangeren, die Kontakt zu an Ringelröteln erkrankten Personen hatten. Schwangere, bei welchen eine akute Parvovirus B19-Infektion diagnostiziert wird, sollen regelmäßig dopplersonographisch untersucht werden. Wird hierüber die Ausbildung einer fetalen Anämie kenntlich, so kann diese durch Erythrozytentransfusion über die Nabelschnurvene meist erfolgreich behandeln.

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    Susanne Modrow

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    Modrow, S. (2014). Ringelröteln. In: S2k-Leitlinie - Labordiagnostik schwangerschaftsrelevanter Virusinfektionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43481-9_17

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