Intrauterine transfusion in 103 fetuses with severe anemia caused by parvovirus infection. A multicenter retrospective study

Kosian, Philipp; Hellmund, Astrid; Geipel, A.; Bald, R.; Geist, Otilia-Maria; Böckenhoff, Paul; Jimenez-Cruz, Jorge; Deja, Maria; Strizek, Brigitte; Berg, Christoph; Gembruch, U

doi:10.1007/s00404-022-06712-z

Cited by 9 publications

(5 citation statements)

References 42 publications

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“…It has to be mentioned that in our cohort, there was a high prevalence of fetuses with hydrops fetalis in the PVB19 subgroup (62%), which is higher than in other reported studies with a prevalence of up to 24% [ 33 ] and 43% in a recent study of our group [ 34 ]. This may have resulted from the selection of fetuses, as only fetuses requiring therapy were included.…”

Section: Discussioncontrasting

confidence: 77%

Fetal NT-proBNP levels and their course in severe anemia during intrauterine treatment

Siebers

Gembruch

Merz

et al. 2023

Arch Gynecol Obstet

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Purpose In adults and fetuses, N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a marker of cardiac failure and myocardial remodelling. We examined the effect of anemia and intrauterine transfusion (IUT) on NT-proBNP concentrations in fetuses with anemia and established gestational age-dependent reference values of a control group. Methods We analyzed NT-proBNP levels in anemic fetuses that underwent serial intrauterine transfusions (IUT), focusing on different causes and severity of anemia and comparing the results to a non-anemic control group. Results In the control group, the average NT-proBNP concentration was 1339 ± 639 pg/ml, decreasing significantly with increasing gestational age (R = − 74.04, T = − 3.65, p = 0.001). Subjects had significantly higher NT-proBNP concentrations before initiation of IUT therapy (p < 0.001), showing fetuses with parvovirus B19 (PVB19) infection having the highest concentrations. Hydropic fetuses also showed an increased NT-proBNP concentration compared to non-hydropic fetuses (p < 0.001). During the course of therapy, NT-proBNP concentration before subsequent IUT decreased significantly from pathologically high levels, while MoM-Hb and MoM-MCA-PSV remained pathological. Conclusion NT-pro BNP levels in non-anemic fetuses are higher than in postnatal life, decreasing with ongoing pregnancy. Anemia is a hyperdynamic state and its severity correlates with circulating NT-proBNP levels. Highest concentrations occur in fetuses with hydrops and with PVB19 infection, respectively. Treatment by IUT leads to a normalisation of NT-proBNP concentrations, so the measurement of its levels may be useful in therapy monitoring.

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Section: Discussioncontrasting

confidence: 77%

Fetal NT-proBNP levels and their course in severe anemia during intrauterine treatment

Siebers

Gembruch

Merz

et al. 2023

Arch Gynecol Obstet

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“…On the other hand, unlike other vertically transmitted viruses, B19 can cause fetal infection in the second and also the third trimesters of pregnancy and might cause fetal loss, which is mainly due to the main effect of the virus that is anemia and damage to the fetal liver and heart (due to expression of P antigen in these organs), rather than teratogenic effect of the virus (which is not proved yet), this could explain the common effect of the virus in the second trimester rather than the first trimester like other teratogenic viruses [24].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence study of Parvovirus B19 among women with miscarriage in Mosul city

Nawfal Buraa,

Baqer Al-Obaidi,

Ali Hussein

2023

DJM

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Background: Miscarriage and stillbirth are among the most common pregnancy complications, and could be caused by several factors, among these factors are viral infections some of them are obvious teratogenic and others are associated with fetal defects like severe anemia in the case of Parvovirus B19 which could be transmitted vertically causing fetal infection and miscarriage or stillbirth. Objective: To investigate the seroprevalence of Parvovirus B19 among women with miscarriage and stillbirth and compare them with normal pregnant women in the city of Mosul-Iraq. Patients and Methods: A case-control study conducted on pregnant aged 16-45 years with miscarriage and stillbirth admitted to Al-Khansa Teaching Hospital in Mousl city. The samples were collected during the period from November 2022 and January 2023 from 160 from pregnant women, 80 of them had miscarriage or stillbirth, and the other 80 had normal uneventfull pregnancy (control). Serum samples were subjected for ELISA Study of anti-B19V IgG and IgM antibodies. Results: This study showed that the seroprevalence rate of anti-B19V IgG among pregnant women was about 23% (37 out of 160), subdivided into (40%) 32 out of 80 patients, and (6.2%) 5 out of 80 controls had positive anti-B19V IgG antibody which is significantly different. And IgM seroprevalence was about 22% (35 out of 160), in which (38.8%) 31 out of 80 patients, and (5%) 4 out of 80 controls had positive anti-B19V IgM antibody. Both anti-B19V IgG and IgM were higher among patients who had stillbirth than those who had miscarriage both qualitatively and quantitatively. On the other hand, there is a highly significant association of anti-B19V IgM positivity with maternal anemia. Conclusion: The study found high association between B19V and miscarriage or stillbirth as compared to normal pregnancy, and this was more common among patients who had stillbirth than those who had miscarriage, with obvious association with maternal anemia, all of the above is among pregnant women from Mosul City in Iraq. Keywords: miscarriage , stilbirth

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“…On suspicion of parvovirus B19 infection in pregnant people, serial ultrasounds with Doppler are conducted to discover any signs of foetal anaemia or hydrops [ 9 ]. There is no treatment or vaccine against the infection, however, intrauterine transfusion to treat anaemia is often successful [ 9 , 10 ]. During the current epidemic, nine individuals had intrauterine transfusions performed, more than during the 2017 epidemic when three were performed.…”

Section: Discussionmentioning

confidence: 99%

Epidemic of parvovirus B19 and disease severity in pregnant people, Denmark, January to March 2024

Nordholm,

Trier Møller,

Fischer Ravn

et al. 2024

Eurosurveillance

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We report an epidemic of parvovirus B19 infections in Denmark during the first quarter of 2024, with a peak incidence 3.5 times higher than during the most recent epidemic in 2017. In total, 20.1% (130/648) of laboratory-confirmed cases were pregnant. Severe adverse outcomes were observed among 12.3% (16/130) of pregnant people and included foetal anaemia, foetal hydrops and miscarriage. Parvovirus B19 infection is not systematically monitored, but a national laboratory-based surveillance system is currently being established in Denmark.

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Intrauterine transfusion in 103 fetuses with severe anemia caused by parvovirus infection. A multicenter retrospective study

Cited by 9 publications

References 42 publications

Fetal NT-proBNP levels and their course in severe anemia during intrauterine treatment

Fetal NT-proBNP levels and their course in severe anemia during intrauterine treatment

Seroprevalence study of Parvovirus B19 among women with miscarriage in Mosul city

Epidemic of parvovirus B19 and disease severity in pregnant people, Denmark, January to March 2024

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