Severe nonimmune hydrops secondary to parvovirus B-19 infection: spontaneous reversal in utero and survival of a term infant

Article Abstract:

Parvovirus B-19 is a virus that causes illness with symptoms of fever, sore throat, sneezing, joint pain, headache, rash, itching, anemia (low red blood cell count), and leukopenia (low white blood cell count). It is estimated that almost half of the adult population has antibodies to this virus, indicating that they have been exposed to the virus at some time in their lives. The virus can be transmitted from person to person by way of sneezing and hand-to-mouth contact. Also, it can be transmitted in blood during transfusions and it can be transmitted across the placenta to the developing fetus. Approximately 33 percent of the pregnant women who are infected transmit the virus to the fetus, and this results in death in 9 percent of the cases. The virus stops new red blood cells from being made, and fetal death is caused by severe anemia, hypoxemia (lack of oxygen), and heart failure. These conditions can lead to the development of nonimmune hydrops fetalis (the accumulation of large amounts of watery fluid in the fetus). The case is reported of a developing fetus with hydrops caused by parvovirus B-19 infection. The pregnant woman gained 22 pounds in a one-month period just prior to week 25 of pregnancy. An ultrasound examination at week 26 showed a fetus with severe hydrops, an abnormally large heart, and an abnormally thick placenta. Blood samples from the mother and the fetus tested positive for parvovirus B-19. During the following weeks, the woman lost 15 pounds due to water loss, and the amniotic fluid (the fluid surrounding the fetus) returned to a normal volume. Another ultrasound was performed and showed that the hydrops had disappeared on its own. The infant was delivered at week 38 of pregnancy and weighed 7.3 pounds. At birth the infant had a large spleen and liver, but by three months of age the infant appeared normal. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Development and progression, Virus diseases, Pregnancy, Parvovirus infections, Virus diseases in pregnancy

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Cordocentesis for the diagnosis and treatment of human fetal parvovirus infection

Article Abstract:

Hydrops fetalis, overall skin swelling of the fetus, is associated with a variety of complications of pregnancy. In most cases, the cause of fetal hydrops is determined by fetal ultrasonography, the use of high frequency sound to visualize internal structures. In some cases, the cause is never discovered, even after autopsy. Recently, maternal infection with the parvovirus B19 has been cited as a cause of fetal hydrops. It is thought that fetal swelling is caused by the severe anemia produced by the parvovirus infection. Cordocentesis is a diagnostic procedure performed during pregnancy which requires removal of small samples of blood from the fetal umbilical cord for analysis. Two pregnancies complicated by hydrops fetalis associated with a parvovirus B19 infection were reviewed. Although blood samples removed by cordocentesis contained specific parvovirus B19 DNA, B19-specific immunoglobulin G antibodies were absent in both cases. Fetal anemia was corrected by fetal blood transfusion, which resolved the fetal hydrops. In both cases healthy infants were delivered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cordocentesis

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Parvovirus infection in pregnancy

Article Abstract:

The parvovirus infection, an infection of extremely small DNA viruses, caused the death of a 20-week-old fetus suffering from hydrops fetalis, a condition resulting in massive amounts of fluid in body tissues (edema). Although 30 to 50 percent of women are susceptible to a parvovirus infection, the consequences of an infection in pregnancy are not well known. The fetus is at great risk of infection after the virus passes into the placenta. Reported cases of the infection in pregnancy are reviewed.

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