title: Detection of parvovirus B19, cytomegalovirus and enterovirus infections in cases of intrauterine fetal death.
abstract: OBJECTIVE
  Maternal infections with parvovirus B19, cytomegalovirus (CMV) and enterovirus have been associated with intrauterine fetal death (IUFD), but the incidence of these infections is not clear. This prospective study was conducted to estimate this incidence.
  
  
  METHODS
  A prospective study of 38 months was conducted on cases of IUFD referred to Huddinge University Hospital, Stockholm, Sweden. Placental biopsies, fetal blood and amniotic fluid were collected from cases of IUFD (n=52). Placental biopsies from normal pregnancies at term (n=53) were used as controls. These tissues were examined for parvovirus B19 DNA, CMV DNA and enterovirus RNA using polymerase chain reaction (PCR). Maternal viral serology was measured in 46 cases and virus isolation for enterovirus in maternal stool samples was performed in 31 cases.
  
  
  RESULTS
  Viral nucleic acid was recovered in at least one tissue sample from six cases of fetal death (parvovirus B19 in two cases, CMV in three and enterovirus in one), while all placental biopsies from controls were found negative. Serological signs of primary maternal infection were found in two of the cases, and virus isolation for enterovirus was negative in all samples examined.
  
  
  CONCLUSIONS
  Parvovirus B19, CMV and enterovirus may be considered as etiologic agents in cases of fetal death. PCR on placental and/or fetal tissue improves diagnostic accuracy for these infections.
authors.affiliation: Department of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, SE-141 86 Huddinge, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Petersson
authors.forename: Oscar
authors.initials: O
authors.lastname: Norbeck
authors.forename: Magnus
authors.initials: M
authors.lastname: Westgren
authors.forename: Kristina
authors.initials: K
authors.lastname: Broliden
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004279:DNA, Viral / Q000032:analysis; D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000453:epidemiology; D005260:Female; D005313:Fetal Death; D006801:Humans; D015994:Incidence; D010322:Parvoviridae Infections / Q000453:epidemiology; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000209:etiology / Q000821:virology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D013548:Sweden / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral