Parvovirus B19, often referred to simply as “parvovirus,” is known for causing Fifth disease or slapped cheek syndrome, a common childhood ailment characterized by a distinctive facial rash. During pregnancy, infection with parvovirus B19 can lead to more serious complications, particularly for the fetus.
Impact on Pregnancy
Fetal Effects
The most severe complication of parvovirus infection during pregnancy is hydrops fetalis, a condition characterized by severe edema (swelling) in the fetus due to heart failure. This occurs because the virus targets rapidly dividing cells, including red blood cell precursors in the fetal bone marrow, leading to severe anemia.
There is an increased risk of miscarriage when infection occurs during the first half of pregnancy. Studies suggest that the miscarriage risk increases if the infection is contracted during the first 20 weeks.
Maternal Effects
– Most infections in pregnant women are asymptomatic or mild, but some may develop arthritis or arthralgias which are usually self-limiting.
Diagnosis
Serological Testing
Diagnosis of parvovirus B19 during pregnancy is primarily done through serological tests, detecting specific antibodies:
– IgM antibodies, indicate recent infection.
– IgG antibodies, indicate past infection and usually confer immunity.
Ultrasound and Other Monitoring
If infection is confirmed or suspected, close monitoring through ultrasound is recommended to check for signs of fetal anemia and hydrops fetalis. In some cases, Doppler ultrasonography may be used to assess the blood flow in the fetal brain, which can indicate anemia.
Management
For many cases, no specific intervention is required other than routine prenatal care and monitoring.
In cases where fetal anemia is severe (especially leading to hydrops), intrauterine blood transfusions may be required to treat the anemia and reduce the risk of hydrops progressing.
Depending on the timing of the infection and its severity, considerations may be made for early delivery if the condition of the fetus is deemed at risk.
Prevention
Hygiene Practices
Encouraging good hygiene practices, such as frequent handwashing, especially after being in environments like schools or daycare centers where the virus is more likely to spread.
Avoidance of Exposure
Pregnant women, especially those who work in schools or daycare centers, should be cautious and consider avoiding close contact with children known to be infected.
Overall, while parvovirus B19 can pose significant risks during pregnancy, with proper monitoring and management, most pregnancies will proceed normally. Awareness and early detection through prenatal screening can greatly assist in managing this infection effectively.