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Parvovirus Infection and Pregnancy

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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  1. Parvovirus Infection and Pregnancy Max Brinsmead PhD FRANZCOG December 2010

  2. 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

  3. 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

  4. 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%

  5. 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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