Parvovirus B19 Infection of Pregnancy

  • often asymptomatic
  • can cause rash with arthralgia / arthritis (i.e. rubella-like)
  • First 20 weeks – 10% excess foetal loss
  • 9-20 weeks – 3% hydrops → 40% foetal mortality
  • ∼ 60% of Australian women of childbearing age are susceptible
  • annual conversion rate varies from 1-2% → 10-15%
    • household contact → 50% seroconversion
    • occupational contact (e.g. school teacher) → 20-30% seroconversion
  • not recommended that susceptible pregnant women stay away from work
    • rather, if come into potential contact → check IgG levels and repeat 3 weeks later in IgG negative women and check foetal ultrasound within 6 weeks if evidence of seroconversion

Hydrops

  • ∼ 3% of parvovirus infection in mothers between 9-20 weeks gestation
  • caused by severe foetal anaemia and presents about 5 weeks after maternal infection
  • ∼ 1 in 3 cases resolves spontaneously
  • outcome is significantly improved in remaining two-thirds by intrauterine transfusion, otherwise 40% mortality!

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