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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

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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