Parvovirus B19 Infection of the Fetus: Histology and In Situ Hybridization

Abstract

Fetal tissues from 16 spontaneous abortions, two terminations, and one perinatal death, 18 of which were associated with maternal human parvovirus B19 infection, were examined for B19 infection by histology and in situ hybridization using a digoxigenin-labeled B19-DNA probe. In 15 spontaneous abortions and one termination, erythroblasts with intranuclear inclusions (lantern cells) reacted with B19-DNA by in situ hybridization. No internal or external fetal malformations were observed. Because 13 (86.7%) spontaneous abortions with lantern cells occurred between the 20th and 28th weeks of gestation, it is postulated that B19 infection may be a particular threat to the fetus during this stage of gestation.

Identification of a novel simian parvovirus in cynomolgus monkeys with severe anemia. A paradigm of human B19 parvovirus infection.

“…1). The other striking finding in some marrows was the presence of intranuclear inclusion bodies, with morphologic characteristics consistent with those observed in tissues infected with Bi 9 and other parvoviruses (10)(11)(12) (Fig. 1).…”

Placental and Fetal Pathology in Intrauterine Viral Infections

“…Maternal infection, when transmitted to the fetus, results in destruction of fetal erythroid cells causing severe anemia, cardiac decompensation with universal hydrops [6,19] and in spontaneous abortion or stillbirth. Since therapeutic blood transfusions are effective in the majority of cases and malformations are rare, termination of pregnancy by induced abortion is not generally indicated.…”

“…In general, when an erythroblastoid placental pattern without a history of blood group incompatibility or an other explanation occurs and the conventional light microscopy is unsuccessful, parvovirus B19 infection should be considered in the differential diagnosis and immunostaining as well as molecular techniques should be used to determine the virus [19]. …”

Risk of fetal hydrops and non-hydropic late intrauterine fetal death after gestational parvovirus B19 infection

“…Later in gestation, B19-derived IUFD is generally associated with fetal hydrops. 11,12 However two recently published case-control studies from Sweden suggested that B19 is also a common cause of non-hydropic late IUFD. 13,14 The concept of B19-derived non-hydropic late IUFD is not supported by the findings of others.…”