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Parvovirus Infection and Pregnancy. Max Brinsmead PhD FRANZCOG December 2010. Parvovirus. Caused by Parvovirus B19 Causes epidemic Fifth Disease or “Slapped Cheek Syndrome” in pre school children.

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Parvovirus Infection and Pregnancy

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Parvovirus infection and pregnancy

Parvovirus Infection and Pregnancy

Max Brinsmead PhD FRANZCOG

December 2010


Parvovirus

Parvovirus

  • Caused by Parvovirus B19

  • Causes epidemic Fifth Disease or “Slapped Cheek Syndrome” in pre school children.

  • When intrauterine infection occurs it affects haemopoeisis. This results in fetal anaemia and hydrops fetalis.

  • However, recovery is usually spontaneous and complete and there are no long term sequelae


Vertical parvovirus transmission

Vertical Parvovirus Transmission

  • 50-66% of pregnant women are Parvovirus immune

  • Most infections occur from the mother’s own pre school child

  • Spread by droplets c sneezing, coughing

  • Incubation period is 4 -14 days

  • Rash occurs on the face but also on hands, wrists & knees

  • Maternal symptoms include polyarthalgia, fever and non specific rash

  • Risk of maternal infection is increased by immune supression and during epidemics


Fetal risk

Fetal Risk

  • Transplacental transmission rate is ~30%

  • Can cause hepatitis and myocarditis

  • 20% risk of fetal death in the 1st trimester

  • Causes up to 3% of miscarriages

  • Risk of hydrops is greatest in the second trimester

  • When a fetal death rate of about 15%

  • But by 20w the risk of fetal death has fallen to 6%


Treatment of intrauterine parvovirus infection

Treatment of Intrauterine Parvovirus Infection

  • Termination of a pregnancy is not required

  • Weekly ultrasound monitoring for signs of hydrops and middle cerebral Dopplers may be undertaken after documented evidence of maternal infection

  • But most affected fetus will recover spontaneously

  • A small number may require intrauterine transfusion for severe anaemia

  • This is ~85% successful


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