最新情報：ジカウイルス曝露の可能性のある妊婦のケアに関する医療従事者のための暫定ガイドライン－アメリカ(海外領土を含む)、2017年7月

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ホーム IMICライブラリ MMWR抄訳 2017年（Vol.66)最新情報：ジカウイルス曝露の可能性のある妊婦のケア･･･

MMWR抄訳

2017/07/28Vol. 66 / No. 29

MMWR66(29):781－793
Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (Including U.S. Territories), July 2017

最新情報：ジカウイルス曝露の可能性のある妊婦のケアに関する医療従事者のための暫定ガイドライン－アメリカ(海外領土を含む)、2017年7月

2017年7月、CDCはWHOアメリカ地域でのジカウイルス疾患の発症率の低下およびジカウイルス免疫グロブリンM(IgM)抗体が感染後12週間持続するとのエビデンスに基づき、ジカウイルス曝露の可能性のある妊婦のケアに関する医療従事者のための暫定ガイドラインを改訂した。以下にその主要な部分を示す。1)アメリカ本土および海外領土におけるすべての妊婦は、現在の妊娠前および妊娠中のジカウイルス曝露の可能性について、妊婦健診のたびに問われるべきである(CDCはすべての妊婦に対しジカウイルス流行地域への渡航を控え、また、これらの地域へ渡航したパートナーとの性行為の際は避妊具の使用を推奨している)、2)ジカウイルス曝露の可能性のある妊婦およびジカウイルス疾患の症状のある妊婦はその症状の原因を診断するための検査を実施する(発症から12週間までのできるだけ早い時期にジカウイルス核酸検査[NAT]および血清検査の実施が推奨されている)、3)ジカウイルス曝露の可能性が持続している無症候性の妊婦は妊娠中3回、ジカウイルスNAT検査を行う(IgM検査は感染後数カ月陽性が持続し、現在の妊娠中の感染か否か確定できないため、NAT検査が推奨される)、4)旅行または性的曝露によりジカウイルス曝露の可能性はあるが、現在は持続していない無症候性の妊婦に定期的な検査は推奨されない、5)ジカウイルス曝露の可能性があり、超音波検査にて胎児に先天性ジカウイルス症候群を認める場合、先天性欠損の原因を確立するためジカウイルス検査を受けるべきである(NATおよびIgM検査)、6)胎盤および胎児組織検査の包括的アプローチが更新された(研究室レベルでジカウイルス感染が確診されていない女性、および胎児または乳児がジカウイルス関連先天性欠損の可能性がある女性に対して行われる)、7)ジカウイルス曝露の可能性が持続していない非妊娠女性の場合、受胎前カウンセリングの一部としてのIgM検査は推奨されない。

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