Parvovirus B19 Infection in Pregnancy

Abstract

Parvoviruses are widespread in nature, with a diversity of virus types affecting many animal species, usually in a species-specific manner. Some members of the parvovirus family give rise to asymptomatic infections but others are highly pathogenic, causing disease not only in adults but also in the young, the newborn and in the fetus. Parvoviruses of animals have for long been regarded as agents of reproductive failure and parvovirus B19 was recognised as a cause of fetal loss in humans in the 1980s. Moreover, following the control of congenital rubella by pre-pubertal and child vaccination, parvovirus B19 infection has emerged as probably the leading cause of viral embryopathy. This review will focus on the laboratory diagnosis of parvovirus B19 infection following exposure in pregnancy. The indications for testing maternal and fetal samples and the interpretation of test results will be discussed and a section is included on clinical management of the infection in pregnancy. The obstetric outcome in pregnant women who seroconvert will be reviewed.

No detection of human bocavirus in amniotic fluid samples from fetuses with hydrops or isolated effusions

“…Therefore, it is not surprising that human parvovirus B19 was found to be a potential problem in pregnancy. 17 Bovine parvovirus and minute virus of canine are members of the genus Bocavirus and cause respiratory tract infections, gastrointestinal tract infections, myocarditis and reproductive failure. Animal bocaviruses are not known to replicate in cells of the erythrocyte lineage and HBoV infection has not yet been associated with anemia.…”

“…18 In fetuses with B19 infection, the main underlying mechanism responsible for fetal pathology is profound anemia resulting in congestive heart failure and fetal hydrops. 17 But severe anemia is not a prerequisite for the development of fetal hydrops. Other pathomechanisms are, i.e.…”

Parvovirus B19 infection in human pregnancy

“…However, even if the fetus is viable, if the degree of hydrops is severe, and there are concerns over neonatal resuscitation and ventilation, delay of delivery and fetal therapy may still be more appropriate 193. Since most fetal adverse effects occur remote from term, a lifesaving procedure may require intrauterine red blood cell transfusion which can reduce the mortality rate 89…”

Parvovirus B19 infection in pregnancy

“…A fetal blood sample should be taken during IUT to perform a measurement of B19V DNA, hemoglobin and reticulocyte counts. If the fetus is near term or at term, delivery should be considered (Cohen and Kumar, 2005). Intrauterine transfusion may be preferable to delivering a severely hydropic fetus, even close to term.…”