Parvovirus - Infectious Diseases in Pregnancy

PARVOVIRUS

Maternal parvovirus B19 infection can cause devastating fetal outcomes such as spontaneous abortion, fetal non-immune hydrops fetalis, and even death. Seroprevalence increases with age and is >60% in adolescents and adults. For susceptible pregnant women, the risk of seroconver-sion ranges from 20% to 50%, depending on closeness to the infectious contact (higher risk for closer contacts such as family members); however, the risk of transplacental in-fection is low. Maternal immune status can be determined byserologic testing; IgM reflects recent infection and IgG indicates infection in the past and immunity. Routine serologic screen-ing in pregnancy is not recommended. Exposed pregnant women should be offered B19-specific IgM and IgG serologic testing. If IgM is positive or seroconversion is confirmed, ultrasound testing for 10 weeks to look for ev-idence of fetal hydrops (ascites, edema), placentomegaly, and growth disturbances is performed. Intrauterine trans-fusions may be necessary if hydrops develops. There is no specific treatment for parvovirus infection. If hydrops does not develop in the fetus, long-term outcomes are good with apparently normal development.