[Virus and other infections in pregnancy: diagnosis and prevention. 2]

The various viral and other microbial infections represent only a small proportion (5-10%) of the noxae which threaten pregnancy and the fetus. However, interest is centered on them because methods of controlling them are now available. These include preventive measures, e.g., active immunization prior to pregnancy for measles, mumps, and rubella; passive prophylaxis with immunoglobulins when the pregnant women comes into contact with, e.g., rubella and varicella, and passive-active prophylaxis with hyperimmunoglobulin and simultaneous active immunization of the newborns from HBsAg and HBeAg-positive resp. anti-HBe-negative mothers and early therapy. The latter is possible for acute herpes simplex and toxoplasmosis infection; it is effective for lues and infections with gonococci, listeriae, beta-hemolytic streptococci, chlamydiae and mycoplasmas. In cases of acute rubella during the first 17 weeks of pregnancy termination of pregnancy must also be considered a prophylactic measure. Laboratory diagnosis today includes, in addition to the conventional tests for antibodies and pathogens, determination of IgG (permanent) and IgM (early) antibodies as well as demonstration of antigens. Depending on the type of pathogen and the diagnostic problem, several types of serologic tests must be combined for rapid determination of the immune status on contact or for detection of acute infections in pregnancy; necessitating in some instances also the isolation of the pathogen. Diagnostic procedures are similar for identifying prenatal and perinatal infection with and without abnormalities in the neonate. Modern laboratory diagnosis is therefore very important for prophylactic and therapeutic measures in pregnancy as well as for further management and supportive care of congenitally infected infants.