PARVOVIRUS B19 INFECTION AND PREGNANCY
DOI:
https://doi.org/10.11603/1681-2727.2025.4.15759Keywords:
parvovirus B19, intrauterine infection, anemia, dopplerography, intrauterine transfusionAbstract
SUMMARY. Parvovirus B19, which is pathogenic for humans, can be transmitted by aerosol, fecal-oral (through dirty hands), contact-wound (through blood transfusion) mechanisms, or transplacentally. Implementation of the last route of transmission can lead to infection of the fetus. Non-immune pregnant women are at risk of intrauterine infection of the fetus with parvovirus B19 with severe complications if transmission of the pathogen occurs in the first or second trimester.
Most immunodeficient patients have mild respiratory symptoms and a maculopapular rash (erythema infectiosum). If the fetus is infected, it may develop anemia, and in severe cases, dropsy. These complications arise due to the tropism of the virus to fetal blood progenitor cells. Fortunately, these effects are rare, and most pregnancies with parvovirus B19 infection are uneventful.
Diagnosis of intrauterine parvovirus infection includes testing the mother for IgG and IgM antibodies, but it is ambiguous. Fetal infection can be diagnosed by PCR of amniotic fluid, but this method is limited because a positive result can only be expected during a relatively short period of viremia.
Fetal therapy for parvovirus B19 infection mainly depends on the signs of hydrops (ascites, skin edema, pleural and pericardial effusions, placental edema, etc.), as well as the severity of fetal anemia, which is indicated by the peak systolic velocity in the middle cerebral artery, assessed by the Doppler method – PSV-MCA. If the PSV-MCA is >1.5 MoM and the gestational age is between 18 and 35 weeks, intrauterine hemotransfusion by cordocentesis is indicated.
Prevention is focused on reducing exposure to high-risk groups, especially pregnant women. There is no vaccine against parvovirus B19.
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