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.
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