Parvovirus B19 infection and its significance in pregnancy (original) (raw)
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Parvovirus B19 and Pregnant Women: A Bibliographic Review
Open Journal of Obstetrics and Gynecology, 2021
Primary infection with parvovirus B19 is an uncommon but serious and treatable cause of chronic anemia in immuno compromised hosts. Widely distributed, it is responsible for a wide range of clinical manifestations, the characteristics and outcome of which depend on the interaction between the viral properties and the physiological and immune status of the infected individuals. Infection during pregnancy can result in fetal anemia, abortion, and hydrops. Pregnancy does not appear to affect the course of the infection, but the infection may affect the pregnancy. The diagnosis of B19V can be made by serological and molecular investigation of the mother, fetus and newborn. In these conditions, it seemed necessary for us to answer in this article the various questions raised by the occurrence of a contagion and/or an infection with Parvovirus B19 during pregnancy. Our objective was to determine at first the nature and the main characteristics of Parvovirus B19 as well as its propagation during the pregnancy and to show its risk for the pregnant woman and her fetus. The importance of the subject is proven by the data on the spread and incidence of the virus. Worldwide, the focus on pregnancy is due to the additional potentially fatal effects on the fetus. This document covers the important aspects of a medical investigation: causes, symptoms, tests and diagnosis.
Parvovirus B19 infection in pregnancy
Archives of Disease in Childhood - Fetal and Neonatal Edition, 1994
ABSTRACT Objectives: This guideline reviews the evidence relating to the effects of parvovirus B19 on the pregnant woman and fetus, and discusses the management of women who are exposed to, who are at risk of developing, or who develop parvovirus B19 infection in pregnancy. Outcomes: The outcomes evaluated were maternal outcomes including erythema infectiosum, arthropathy, anemia, and myocarditis, and fetal outcomes including spontaneous abortion, congenital anomalies, hydrops fetalis, stillbirth, and long-term effects. Evidence: Published literature was retrieved through searches of PubMed and The Cochrane Library on July 8, 2013, using appropriate controlled vocabulary (MeSH terms "parvovirus" and "pregnancy") and key words (parvovirus, infection, pregnancy, hydrops). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions but results were limited to English or French language materials. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty. Values: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Recommendations 1. Investigation for parvovirus B19 infection is recommended apart of the standard workup for fetal hydrops or intrauterine fetal death. (II-2A) 2. Routine screening for parvovirus immunity in low-risk pregnancies is not recommended. (II-2E) 3. Pregnant women who are exposed to, or who develop symptoms of, parvovirus B19 infection should be assessed to determine whether they are susceptible to infection (non-immune) or have a current infection by determining their parvovirus B19 immunoglobulin G and immunoglobulin M status. (II-2A) 4. If parvovirus B19 immunoglobulin G is present and immunoglobulin M is negative, the woman is immune and should be reassured that she will not develop infection and that the virus will not adversely affect her pregnancy. (II-2A) 5. If both parvovirus B19 immunoglobulin G and immunoglobulin M are negative (and the incubation period has passed), the woman is not immune and has not developed the infection. She should be advised to minimize exposure at work and at home. Absence from work should be considered on a case-by-case basis. (II-2C) Further studies are recommended to address ways to lessen exposure including the risk of occupational exposure. (III-A) 6. If a recent parvovirus B19 infection has been diagnosed in the woman, referral to an obstetrician or a maternal-fetal medicine specialist should be considered. (III-B) The woman should be counselled regarding risks of fetal transmission, fetal loss, and hydrops and serial ultrasounds should be performed every 1 to 2 weeks, up to 12 weeks after infection, to detect the development of anemia (using Doppler measurement of the middle cerebral artery peak systolic velocity) and hydrops. (III-B) If hydrops or evidence of fetal anemia develops, referral should be made to a specialist capable of fetal blood sampling and intravascular transfusion. (II-2B).
Parvovirus B19 infection in human pregnancy
BJOG: An International Journal of Obstetrics & Gynaecology, 2011
Human parvovirus B19 infection is widespread. Approximately 30-50% of pregnant women are non-immune and vertical transmission is common following maternal infection in pregnancy. Fetal infection may be associated with a normal outcome but fetal death may also occur without ultrasound evidence of infections sequelae. B19 infection should be considered in any case of nonimmune hydrops. Diagnosis is mainly through serology and PCR. Surveillance requires sequential ultrasound and Doppler screening for signs of fetal anemia, heart failure, and hydrops. Immunoglobulins antiviral and vaccination are not yet available but intrauterine transfusion in selected cases can be lifesaving.
Risk factors for parvovirus B19 infection in pregnancy
JAMA: The Journal of …, 1999
Author Affiliations: Department of Epidemiology Research, Danish Epidemiology Science Centre (Drs Valeur-Jensen, Westergaard, Andersen, Aaby, and Melbye and Ms CB Pedersen), and the Departments of Virology (Dr Jensen) and Clinical Biochemistry (Drs Lebech and BN ...
Jognn-journal of Obstetric Gynecologic and Neonatal Nursing, 2002
Parvovirus B19 is a common, self-limiting, usually benign childhood virus that causes erythema infectiosum, also known as fifth disease. Acute infection in pregnancy can cause B19 infection in the fetus, leading to nonimmune fetal hydrops or fetal loss, depending on gestational age at the time of infection. Susceptibility to parvovirus B19 infection should be determined in selected pregnant women at high risk for exposure, and counseling should be provided regarding prevention, testing, and treatment options if exposed.
The effects of Parvovirus B19 infection on pregnant women and fetus
Journal of Immunology and Clinical Microbiology
Background: Human parvovirus B19 infection during pregnancy may cause fetal loss. The aim of this study was to detect the incidence of B19 infection in cases of nonimmune hydrops fetalis (NIHF), spontaneous abortion, intrauterine fetal death (IUFD) and in healthy pregnant women. Material and Methods: Serum samples of pregnant women with NIHF (9), spontaneous abortion (27), IUFD (5) and healthy pregnant women (47) were tested by nested PCR to detect B19 DNA and by ELISA test for B19 specific IgM and IgG antibodies. In other case series of the study, paraffin-embedded fetal and placental tissue samples from 33 NIHF cases and 19 spontaneous abortion cases and placental tissues from 40 normal pregnant women at term were analyzed for B19 DNA by nested PCR. Results: B19 infection was diagnosed by PCR and ELISA tests using serum samples in 4 (44%) of 9 NIHF cases and 9 (33%) of 27 spontaneous abortion cases and in 1 (20%) of 5 IUFD cases. In addition, B19 IgG prevalence was found to be 51% (24/47) in the control group. In other case series, the presence of B19 DNA in fetal and placental tissue samples was found in 14 (42.4%) of 33 NIHF cases and 6 (31.5%) of 19 spontaneous abortion cases, while in none of 40 placental tissues samples from the control group. Conclusion: Our findings show that the incidence of parvovirus B19 infection in NIHF and spontaneous abortion cases is relatively high. Nested PCR and ELISA tests should be used together for the early diagnosis of B19 infection in pregnant women.