Parvovirus B19

Question 1

Define Parvovirus B19 in pregnancy.

Answer 1

Erythema infectuosum (Fifth disease) caused by PVB19

Question 2

What is the aetiology of Parvovirus B19 in pregnancy?

Answer 2

Aerosol transmission, also blood borne.

DDX: RUBELLA!

Question 3

What are some risk factors for Parvovirus B19?

Answer 3

Children or susceptible adults

Question 4

Summarise the epidemiology of Parvovirus B19.

Answer 4

Common infection, 60% immune by 20

1/400 pregnancies

Question 5

What are the symptoms of Parvovirus B19 in pregnancy?

Answer 5

Rash, malaise, fever, arthropathy

May be asymptomatic

Question 6

What are some signs of Parvovirus B19?

Answer 6

Slapped cheek rash

May have purpura

May have erythema multiforme

Question 7

What are some investigations for Parvovirus B19 in pregnancy?

Answer 7

Blood: PVB19 serology (IgM acute, IgG past). Rubella serology (similar presentation)

USS: fetal anomaly scan at 4wk pot onset of illness, then 1-2wk intervals until 30/40.

Question 8

What is the management for Parvovirus B19 in pregnancy?

Answer 8

Maternal: Symptomatic treatment, self limiting

Neonate: Intrauterine blood transmision (if fetal hydrops)

Question 9

What are the complications associated with Parvovirus B19? What is the prognosis of Parvovirus B19?

Answer 9

Maternal: Aplastic anaemia, arthritis, myocarditis, nephritis.

Fetus: Miscarriage15%, fetal hydrops 3%.

Untreated fetal hydrops has 50% mortality, reduced to 18% if IUBT. No congenital abnormalities.