妊娠合并下生殖道人乳头瘤病毒感染临床分析

Clinical Analyses of Pregnancy Complicated with Genital Human Papillomavirus Infection

目的:探讨妊娠期下生殖道人乳头瘤病毒(HPV)感染的特点、诊治以及HPV持续感染患者的妊娠时机。方法:对北京协和医院45例妊娠合并生殖道HPV感染患者进行回顾性分析。结果:26例(58%)表现为下生殖道疣,18例(38%)为亚临床感染,1例(4%)为潜伏感染。10例(22%)患者合并其他感染。16例(36%)患者接受药物、激光、冷冻或手术治疗。39例患者足月分娩,未发现呼吸道乳头瘤病新生儿。产后复查3例患者仍有下生殖道疣。13例患者复查宫颈薄层液基细胞学涂片,4例患者异常。5例患者复查HC2,2例阳性。结论:妊娠期下生殖道HPV感染发生新生儿呼吸道乳头瘤病率很低,但下生殖道HPV感染孕妇易合并其他下生殖道感染。持续HPV感染患者可在病毒负荷低时计划妊娠。

Objective：To determine the clinical characteristics, diagnosis and treatment of genital human papillomavirus （HPV） infection during pregnancy and whether people have persistent HPV infection may pregnant. Methods： Forty- five pregnant women with genital HPV infection in PUMCH were analyzed retrospectively. Results： In these forty- five patients with genital HPV infection, 26（58%） cases of genital warts, 18（38%） subclinical infection, and 1（4%） latent infection with positive HPV- DNA but no any symptom and pathological changes. 10（22%） patients were involved simultaneously other genital infection. Only 16 （36%） patients received treatment of drug, laser, cryosurgery or surgery. 39 patients, including 3 patients with persistent HPV infection had full- term pregnancy. No respiratory papillomatosis cases were idantified in all newborns. 3 patients kept genital warts in the postnatal recheck. 13 patients had thinprep cytological test again and 4 were abnormal. 5 patients had hybrid capture （HC2） again and 2 were positive. Conclusions： Prevalence of respiratory papillomatosis is rare in newborn with maternal genital HPV infection that often complicated with other genital infection. The patients with persistent HPV infection may pregnant when virus burden is low.