Parvovirus B19 infection in pregnancy.
Parvovirus B19 is a small single-stranded DNA virus and a potent inhibitor of erythropoiesis, due to its cytotoxicity to erythroid progenitor cells. Infection with parvovirus B19 during pregnancy can cause several serious complications in the fetus, such as fetal anemia, neurological anomalies, hydrops fetalis, and fetal death. Early diagnosis and treatment of intrauterine parvovirus B19 infection is essential in preventing these fetal complications. Testing maternal serum for IgM antibodies against parvovirus B19 and DNA detection by PCR can confirm maternal infection. If maternal infection has occurred, ultrasound investigation of the fetus and measurement of the peak systolic flow velocity of the middle cerebral artery are sensitive non-invasive procedures to diagnose fetal anemia and hydrops. Intrauterine transfusion is currently the only effective treatment to alleviate fetal anemia, but if the fetus is (near) term, induction of delivery should be considered. Most maternal infections with parvovirus B19 occur through contact with infected children at home. Individual counseling of susceptible pregnant women will reduce unnecessary fetal deaths.
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
Eveline P
EP
de Jong
Timo R
TR
de Haan
Aloys C M
AC
Kroes
Matthias F C
MF
Beersma
Dick
D
Oepkes
Frans J
FJ
Walther
D000740:Anemia / Q000151:congenital / Q000175:diagnosis / Q000209:etiology; D001805:Blood Transfusion, Intrauterine; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D010322:Parvoviridae Infections / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy / Q000635:transmission; D016732:Parvovirus B19, Human; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography