Intrauterine management of fetal parvovirus B<sub>19</sub> infection

Schild, R. L.; Bald, R.; Plath, H.; Eis‐Hübinger, Anna Maria; Enders, Gisela; Hansmann, M.

doi:10.1046/j.1469-0705.1999.13030161.x

Cited by 83 publications

(63 citation statements)

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“…The chance of an adverse fetal outcome after infection seems to be greatest between 11 and 23 weeks of gestation, which correlates with the hepatic period of hematopoietic activity (366,367). Cordocentesis allows precise assessment of fetal anemia, which might then be corrected by intravenous transfusion of erythrocytes (292). Accordingly, in series of hydropic fetuses the case fatality rate may be almost 50% (102,195,317), but (ii) Congenital anemia.…”

Section: B19 Infection In Pregnancy (I) Hydrops Fetalismentioning

confidence: 99%

Human Parvovirus B19

2002

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Parvovirus B19 (B19) was discovered in 1974 and is the only member of the family Parvoviridae known to be pathogenic in humans. Despite the inability to propagate the virus in cell cultures, much has been learned about the pathophysiology of this virus, including the identification of the cellular receptor (P antigen), and the control of the virus by the immune system. B19 is widespread, and manifestations of infection vary with the immunologic and hematologic status of the host. In healthy immunocompetent individuals B19 is the cause of erythema infectiosum and, particularly in adults, acute symmetric polyarthropathy. Due to the tropism of B19 to erythroid progenitor cells, infection in individuals with an underlying hemolytic disorder causes transient aplastic crisis. In the immunocompromised host persistent B19 infection is manifested as pure red cell aplasia and chronic anemia. Likewise, the immature immune response of the fetus may render it susceptible to infection, leading to fetal death in utero, hydrops fetalis, or development of congenital anemia. B19 has also been suggested as the causative agent in a variety of clinical syndromes, but given the common nature, causality is often difficult to infer. Diagnosis is primarily based on detection of specific antibodies by enzyme-linked immunosorbent assay or detection of viral DNA by dot blot hybridization or PCR. Treatment of persistent infection with immunoglobulin reduces the viral load and results in a marked resolution of anemia. Vaccine phase I trials show promising results

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Section: B19 Infection In Pregnancy (I) Hydrops Fetalismentioning

confidence: 99%

Human Parvovirus B19

2002

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“…Retrospective studies have shown B19 infection to be responsible for 10-50% of cases of hydrops fetalis, in which the etiology was unknown . Two reports have proposed management plans for pregnant women exposed to individuals with B19 infection and for women shown to be infected upon serological testing (Levy et al 1997;Schild et al 1999). These studies, however, showed some discrepancies, and further study is necessary in order to establish clinical practice guidelines.…”

confidence: 99%

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Chisaka

Itō

Niikura

et al. 2006

Tohoku J. Exp. Med.

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Parvovirus B19 is a small DNA virus. Infection with parvovirus B19 during pregnancy may cause serious complications in the fetus, including hydrops fetalis and fetal death. The purpose of the present study is to clarify the clinical manifestations and outcomes of parvovirus B19 infection during pregnancy. This prospective study enrolled 478 women with suspected B19 infections during pregnancy between 1999 and 2004. One hundred cases (21%) of B19 infection were detected in 478 pregnant women who had been exposed to B19. Serological infection was confirmed by measurement of B19-specific IgM and IgG in sera. Forty-nine cases reported maternal clinical symptoms and 51 cases were asymptomatic. Facial rash was the most common symptom, with 51% (25/49) of the symptomatic patients complaining of either a facial, body or limb rash. The most common infectious source was children living in the home. Overall, the incidence of adverse fetal effects (including hydrops fetalis and fetal death) related to intrauterine B19 infection was 7% (7/100), and all seven cases were exposed to B19 infection before 20 weeks of gestation. Although half of the cases with parvovirus B19 infections during pregnancy were asymptomatic, patients with adverse fetal effects tended to be symptomatic including rash and fever. These clinical data may supply useful information to produce clinical guidelines for managing B19 infection during pregnancy. parvovirus B19; pregnancy; clinical manifestation; hydrops fetalis; fetal outcome

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“…Management with intrauterine transfusion (IUT) can correct fetal anaemia and may reduce the mortality of fetal Parvovirus B19 infection significantly. Fetal mortality rate due to Parvovirus B19-induced hydrops has been reported as high as 30% without IUT 5,6 . Management with IUT guided by appropriate anaemia Z-scores in the absence of fetal myocarditis may reduce mortality by more than 50% 5 .…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental outcome after intrauterine red cell transfusion for Parvovirus B19-induced fetal hydrops

Dembinski¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Intrauterine management of fetal parvovirus B₁₉ infection

Cited by 83 publications

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Human Parvovirus B19

Human Parvovirus B19

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Neurodevelopmental outcome after intrauterine red cell transfusion for Parvovirus B19-induced fetal hydrops

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Intrauterine management of fetal parvovirus B19 infection

Cited by 83 publications

References 0 publications

Human Parvovirus B19

Human Parvovirus B19

Clinical Manifestations and Outcomes of Parvovirus B19 Infection during Pregnancy in Japan

Neurodevelopmental outcome after intrauterine red cell transfusion for Parvovirus B19-induced fetal hydrops

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Intrauterine management of fetal parvovirus B₁₉ infection