Slovenian recommendations for parvovirus B19 infection in pregnancy

Abstract

Parvovirus B19 (B19V) causes a mild disease called erythema infectiosum, also known as the fifh disease that affects mostly children and young adults. The virus can be transferred to the fetus during pregnancy in 31 to 51 % of the cases and can cause severe anaemia, non-immune hydrops fetalis or fetal death due to inhibition of erythropoiesis. It also affects the heart muscle, central nervous system, bones, and most likely can cause a subsequent arrest in children’s neurological development. It is estimated that 25–45 % of pregnant women are seronegative with a high risk of infection during pregnancy. A B19V infection in pregnant women is determined by detecting specific IgM and IgG antibodies, and in case of doubt, by using PCR method to detect viral DNA. Fetal infection with B19V is confirmed by detecting viral DNA in the amniotic fluid. In the case of either a suspected or confirmed fetal infection we monitor the fetus by ultrasound screening in a tertiary centre. We treat the fetus with an intrauterine transfusion at the first signs of anaemia or hydrops. To prevent fresh infections with B19V during pregnancy we should raise awareness amongst women and healthcare workers about the risks it poses for the fetus. The recommendations for management of women who are exposed to, are at risk of developing, or have developed B19V infection in pregnancy are published in this article.

Keywords

• erythema infectiosum
• anemija pri plodu
• fetalna smrt
• neimunski fetalni hidrops (niFH)
• intrauterina transfuzija (iUt)