Identification and management of congenital parvovirus B19 infection

Abstract

Parvovirus B19 (B19V) infection is well known for its mild, self-limiting clinical presentations in children, such as erythema infectiosum. Approximately 40% of women of childbearing age are susceptible to B19V infection. While maternal B19V infection usually has a good prognosis, B19V can cause severe fetal anaemia and pregnancy loss due to its ability to suppress erythroid progenitor cells. Non-invasive ultrasound monitoring for fetal anaemia is usually performed if maternal seroconversion occurs in the first 20 weeks of gestation, with amniocentesis for fetal infection reserved for those who first present with fetal anaemia or hydrops of unknown cause. Intrauterine transfusion is the standard treatment for severe fetal anaemia and is associated with a significant improvement in survival. However, survivors of hydrops fetalis may have a higher rate of long-term neurodevelopmental complications compared with non-hydropic survivors. This review aims to synthesise published data on the diagnosis, surveillance and outcomes of congenital parvovirus infection to assist clinicians in diagnosing and managing this important condition.

40 years of prenatal diagnosis in 2020

“…We also publish the latest on congenital toxoplasmosis, including a large case series gathered from 30 fetal medicine centers across France, 18 and a review of pharmacotherapy from Mandelbrot 19 . We conclude the issue with reviews on other important infections in pregnancy, including HIV, 20 syphilis, 21 and parvovirus B19 22 …”

“…19 We conclude the issue with reviews on other important infections in pregnancy, including HIV, 20 syphilis, 21 and parvovirus B19. 22 Diana Bianchi, Editor-in-Chief 2007-2020. and clinical communities. We thank all our authors, reviewers and readers for their support for the journal's work during the pandemic.…”

Parvovirus B19 in Pregnancy: A Case Review

“…As seen in other developed countries, the seropositivity in the US increases with age. For example, 5% to 10% of children aged 2 to 5 years will be seropositive, 50% will be seropositive by age 15 years, and 60% will have evidence of previous parvovirus B19 infection by age 30 years 2,4,5 . Although 30% to 40% of adults are not immune, the incidence of acute infection during pregnancy is only 1% to 2%, with an annual seroconversion rate of 1.5% 4,5,9 …”

“…Parvovirus B19 belongs to a larger group of viruses in the Parvoviridae family, which includes several pathogenic animal viruses not known to be infectious to humans 4–6 . Likewise, human parvovirus B19 cannot be transmitted to animals.…”

“…Human parvovirus B19 is a small single‐strand DNA virus that targets rapidly growing erythroid progenitor cells 4,8 . These cells, found in the bone marrow, peripheral blood, the fetal liver, and umbilical cord, are important precursors to the formation of erythrocytes (red blood cells) 4,8 . Although infection typically causes mild upper respiratory symptoms and arthralgias, in rare cases, parvovirus B19 can trigger severe hemolytic reactions such as chronic anemia, aplastic crisis, and hydrops fetalis 4,8 …”