Prenatal diagnosis of congenital parvovirus B19 infection: value of serological and PCR techniques in maternal and fetal serum

Dieck, Dorothea; Schild, R. L.; Hansmann, M.; Eis‐Hübinger, Anna Maria

doi:10.1002/(sici)1097-0223(199912)19:12<1119::aid-pd716>3.0.co;2-x

Cited by 53 publications

(20 citation statements)

References 32 publications

(25 reference statements)

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“…For the diagnosis of congenital infection, detection of B19 DNA should be performed, since only 13.3% of the infected neonates presented with IgM at birth. Both the immaturity of the fetal immune system and B19 antigenicity can contribute to the absence of IgM (6,8). It should be also be noted that in the absence of maternal diagnosis of infection, the occurrence of fetal deaths could also be ascribed to B19.…”

Section: Discussionmentioning

confidence: 99%

Gestational and Fetal Outcomes in B19 Maternal Infection: a Problem of Diagnosis

et al. 2011

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Parvovirus B19 infection during pregnancy is a potential hazard to the fetus because of the virus' ability to infect fetal erythroid precursor cells and fetal tissues. Fetal complications range from transitory fetal anemia and nonimmune fetal hydrops to miscarriage and intrauterine fetal death. In the present study, 72 pregnancies complicated by parvovirus B19 infection were followed up: fetal and neonatal specimens were investigated by serological and/or virological assays to detect fetal/congenital infection, and fetuses and neonates were clinically evaluated to monitor pregnancy outcomes following maternal infection. Analysis of serological and virological maternal B19 markers of infection demonstrated that neither B19 IgM nor B19 DNA detected all maternal infections. IgM serology correctly diagnosed 94.1% of the B19 infections, while DNA testing correctly diagnosed 96.3%. The maximum sensitivity was achieved with the combined detection of both parameters. B19 vertical transmission was observed in 39% of the pregnancies, with an overall 10.2% rate of fetal deaths. The highest rates of congenital infections and B19-related fatal outcomes were observed when maternal infections occurred by the gestational week 20. B19 fetal hydrops occurred in 11.9% of the fetuses, and 28.6% resolved the hydrops with a normal neurodevelopment outcome at 1-to 5-year follow-up. In conclusion, maternal screening based on the concurrent analysis of B19 IgM and DNA should be encouraged to reliably diagnose maternal B19 infection and correctly manage pregnancies at risk.Parvovirus B19 is a common human pathogen. The infection can occur asymptomatically, or it can be associated with a broad range of clinical features such as erythema infectiosum, postinfectious arthropathy, or transient aplastic crises in patients with hemolytic anemia and can complicate a pregnancy course. B19 is mainly transmitted via respiratory secretions and vertically by the transplacental route. B19 iatrogenic transmission has also been described by blood products (3).The prevalence of specific B19 IgG ranges from 15 to 60% in children to 30 to 60% in adults and is Ͼ85% in the geriatric population (13,14,18). In pregnant women, susceptibility to B19 infection has been estimated at 26 to 43.5%, with a seroconversion incidence of 0.61 to 2.4%. In an epidemic period, the incidence may increase up to 13.5% (12,15,22).The infection during pregnancy can have very different outcomes, ranging from the absence of maternal and fetal symptoms to transitory fetal anemia and nonimmune hydrops fetalis (NIHF) to miscarriage and intrauterine fetal death (IUFD). Fetal injuries such as fetal myocarditis, endothelial lesions, and fetal cerebral damages have been reported (9,19,21). Thrombocytopenia secondary to B19 infection can also occur (19), as well as congenital anomalies, including chronic anemia (4), meconium peritonitis (24), congenital heart disease (23), fetal hepatic calcifications (20), and bilateral opacification of the cornea (17). The pathogenesis of fetal damages d...

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Section: Discussionmentioning

confidence: 99%

Gestational and Fetal Outcomes in B19 Maternal Infection: a Problem of Diagnosis

et al. 2011

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“…The sensitive polymerase chain reaction for DNA detection might be the best indicator of infection, not only in fetal but also in maternal blood, at least in doubtful cases. 16 The virus does not grow well in routine cell culture. Maternal serum ␣-fetoprotein levels can be elevated in women infected by parvovirus B19.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Hydrops Fetalis Secondary to Parvovirus B19 Infections

Raff²,

Muallem³

et al. 2003

The Journal of the American Board of Family Medicine

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“…Furthermore, Nunoue et al (2002) strongly suggest that prospective studies to evaluate the relationship between time of infection and IUFD, with and without signs of foetal hydrops, are necessary. In fact, B19 PCR may be the most sensitive way of diagnosing intrauterine B19 infection especially since more than 50% of infected foetuses test negative for B19 IgM (Dieck et al, 1999).…”

Section: Successfulmentioning

confidence: 55%

Human Parvovirus B19: Molecular Virology, Clinical Features, Prevalence, Diagnosis and Control

Corcoran¹,

Doyle²

2006

Congenital and Other Related Infectious Diseases of the Newborn

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Parvovirus B19-introductionParvovirus B19 (B19) is an erythrovirus and recent studies have classified B19 as a genotype 1 erythrovirus with genotypes 2 (erythrovirus K71 or A6) and 3 (erythrovirus V9) also present in the human population. B19 is a significant human pathogen which can cause foetal hydrops and foetal death if maternal infection, followed by transplacental QA :1 foetal infection, occurs during pregnancy. The virus is also transmitted by inter-personal contact and potentially via blood product administration. Symptoms of B19 infection include malaise, rash and anthralgia. Significantly, maternal B19 infection during pregnancy can be asymptomatic and so careful monitoring of at-risk pregnancies is recommended. Both antibody-and cell-mediated immunity play an important role in the anti-viral response and effective diagnostic test systems, for both B19 antibody and DNA detection, are now available. B19-induced foetal hydrops can be effectively treated by intrauterine blood transfusion; however, no vaccine is available to prevent infection at present.

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Prenatal diagnosis of congenital parvovirus B19 infection: value of serological and PCR techniques in maternal and fetal serum

Cited by 53 publications

References 32 publications

Gestational and Fetal Outcomes in B19 Maternal Infection: a Problem of Diagnosis

Gestational and Fetal Outcomes in B19 Maternal Infection: a Problem of Diagnosis

Hydrops Fetalis Secondary to Parvovirus B19 Infections

Human Parvovirus B19: Molecular Virology, Clinical Features, Prevalence, Diagnosis and Control

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