FETAL PATHOLOGY IN INTRAUTERINE DEATH DUE TO PARVOVIRUS B19 INFECTION

Objectives To study the pathological features of fetuses dying because of parvovirus B19 infection, with particular reference to the presenc e of hydrops; to assess the usefulness of immunochemistry as a screeni ng method for the detection of parvovirus infection at post-mortem exa mination. Design Review of clinical, sonographic, serological and path ological data; immunohistochemical staining of post-mortem tissue. Sam ple Cases of intrauterine fetal death occurring during the 18-month pe riod January 1993 to June 1994 inclusive, referred for post-mortem exa mination to the Pathology Department, Royal Victoria Infirmary, Newcas tle upon Tyne. Results Eleven cases of fetal death due to parvovirus i nfection were identified. Seven fetuses were less than 18-week size. T hree fetuses showed conspicuous hydropic change. One of the 11 cases w as detected for the first time by retrospective immunochemical screeni ng. Of cases originating from the Newcastle district, parvovirus infec tion was responsible for about 10% of all nonmalformed fetal deaths oc curring between 10 and 24 weeks of gestation referred for pathological examination. Conclusions During the period of study, parvovirus infec tion was a relatively common cause of mid-trimester fetal death. Many fetuses dying because of this infection are not noticeably hydropic, a nd the possibility of parvovirus infection should be considered in any case of intrauterine fetal death. Immunochemistry can be used to conf irm the histopathological diagnosis, and may be of particular help whe re there is advanced autolysis; immunohistochemical screening may dete ct occasional cases not initially identified by examination of routine ly stained tissue sections.