Intrauterine transfusion for parvovirus B19 infection: long-term neurodevelopmental outcome

Jong, Eveline P. de; Lindenburg, Irene T.M.; Klink, Jeanine M.M. van; Oepkes, Dick; Kamp, Inge L. van; Walther, Frans J.; Lopriore, Enrico

doi:10.1016/j.ajog.2011.12.035

Cited by 76 publications

(65 citation statements)

References 29 publications

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“…This leads to the obvious suggestion that IUT should preferably be done before hydrops develops. In the absence of screening programs for parvovirus susceptibility or infection in pregnant women, the majority is still referred only after the detection of hydrops [26,27,28,29]. …”

Section: Indications For Iutmentioning

confidence: 99%

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Lindenburg

Kamp

Oepkes³

2014

Fetal Diagn Ther

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143

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Fetal anemia is a serious complication in pregnancy and associated with perinatal mortality and morbidity. During 25 years of worldwide experience with intravascular intrauterine blood transfusion, a variety of indications have been described. Intrauterine transfusion (IUT) treatment is considered most successful for fetal anemia due to red cell alloimmunization. Moreover, the use of this procedure has also been reported in pregnancies with parvovirus B19 infection, fetomaternal hemorrhage and placental chorioangiomas, for example. This review focuses on the current indications of intrauterine blood transfusions. In addition, we describe the potential complications of IUT treatment.

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Section: Indications For Iutmentioning

confidence: 99%

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Lindenburg

Kamp

Oepkes³

2014

Fetal Diagn Ther

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143

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“…Finally, the infected fetus may show presence of virus at birth [239,240]. Congenital infections have been sporadically associated with neonatal anemia or anomalies [241], while their possible consequences on the neurological development are currently investigated [242][243][244].…”

Section: Intrauterine Infection and Fetal Damagementioning

confidence: 99%

Parvovirus B19 Achievements and Challenges

Gallinella

2013

ISRN Virology

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Parvovirus B19 is a widespread human pathogenic virus, member of the Erythrovirus genus in the Parvoviridae family. Infection can be associated with an ample range of pathologies and clinical manifestations, whose characteristics and outcomes depend on the interplay between the pathogenetic potential of the virus, its adaptation to different cellular environments, and the physiological and immune status of the infected individuals. The scope of this review is the advances in knowledge on the biological characteristics of the virus and of virus-host relationships; in particular, the interactions of the virus with different cellular environments in terms of tropism and ability to achieve a productive replicative cycle, or, on the contrary, to establish persistence; the consequences of infection in terms of interference with the cell physiology; the process of recognition of the virus by the innate or adaptive immune system, hence the role of the immune system in controlling the infection or in the development of clinical manifestations. Linked to these issues is the continuous effort to develop better diagnostic algorithms and methods and the need for development of prophylactic and therapeutic options for B19V infections.

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“…Indeed, according to a few reported cases, cerebral damage secondary to congenital B19V infection seems to carry a prognosis similar to that of other etiologies of cerebellar injury. In their series of 28 children treated with IUT in the context of B19V infection, de Jong et al [9] found severe neurodevelopmental impairment in 3 children. One postnatal MRI performed on one of these children revealed atrophy of the cerebellar vermis.…”

Section: Discussionmentioning

confidence: 99%

“…Since the pathophysiological mechanisms of brain injury induced by fetal B19V infection remain unclear in the literature [9,11], our aim was to explore the hypotheses that have been previously suggested: (1) fetal cerebral injuries could be caused by ischemic stroke associated with severe anemia, similar to cases of severe fetal anemia associated with red blood cell alloimmunization [28][29][30]; (2) cerebral injuries could be linked to a direct effect of B19V [19]; and (3) cerebral injuries could be related to hemodynamic changes in cerebral blood flow when IUTs are performed, with sudden high increases in hemoglobin level [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, among the survivors of 3 cohorts of B19V-infected fetuses, 16% of the infants presented with neurodevelopmental impairment at a median age of 5 years (range: 13 months to 13 years) [7][8][9][10]. However, the pathophysiological mechanisms of brain injury induced by fetal B19V infection remain unclear in the literature [9,11]. There are only few reports of isolated cases of prenatal neuroimaging findings related to congenital B19V infection [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Fetal Brain Injury Associated with Parvovirus B19 Congenital Infection Requiring Intrauterine Transfusion

et al. 2018

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Background: Infection with parvovirus B19 (B19V) during pregnancy may cause severe fetal anemia, hydrops, and fe tal death. Furthermore, neurodevelopmental impairment among survivors may occur despite appropriate prenatal management, including intrauterine transfusion (IUT). Objectives: Our primary objective was to describe cerebral lesions on MRI in fetuses with severe anemia requiring IUT for B19V infection. Our secondary objective was to search for clinical and biological characteristics associated with the occurrence of such lesions. Study Design: We performed a retrospective review of data on fetuses infected with B19V and requiring at least one IUT between 2005 and 2016. Fetuses with abnormal cerebral MRI results in the 3rd trimester were compared to those with normal MRI results. Results: Of 34 transfused fetuses, 26 children were born at full term. Five intrauterine fetal deaths, 1 neonatal death, and 2 terminations of pregnancy occurred. Cerebral anomalies were observed in 7/27 fetuses on MRI, including cerebellar hemorrhage or a small cerebellum. Only viral load in fetal blood appeared to be associated with brain lesions (11.5 log₁₀ copies/mL [10.5–12.5] in case of abnormal MRI results vs. 9.5 log₁₀ copies/mL [7.8–10.0]; p = 0.05). Conclusions: Among the fetuses transfused for B19V infection, 26% presented with prenatal abnormal cerebral imaging results. In our study, viral load in fetal blood appeared to be the only factor associated with fetal brain lesions.

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Intrauterine transfusion for parvovirus B19 infection: long-term neurodevelopmental outcome

Cited by 76 publications

References 29 publications

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Parvovirus B19 Achievements and Challenges

Fetal Brain Injury Associated with Parvovirus B19 Congenital Infection Requiring Intrauterine Transfusion

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