INTRAUTERINE PARVOVIRUS B19 INFECTION AND MECONIUM PERITONITIS

B19 fetal infection has been associated with hydrops or fetal death. W e report four cases of meconium peritonitis in hydropic fetuses with l aboratory diagnosis of B19 infection. Parvovirus B19 DNA was detected by in situ hybridization both in cord blood and in amniotic cells in t hree fetuses, while in one case only cord blood was available and prov ed positive. Signs of active or recent B19 infection in maternal serum samples were documented only in two cases, which proved positive for specific IgM antibodies anti-B19. Maternal B19 infections were asympto matic and fetal anomalies were observed during a routine ultrasound sc an. A common feature of the hydropic fetuses was the presence of abdom inal ascites concomitant with or preceding alterations suggesting meco nium peritonitis. The four pregnancies had a preterm outcome: in two c ases infants recovered following surgical treatment, in one case spont aneously, and the other one was stillborn. Since vascular inflammation has been documented in B19 infection and congenital bowel obstruction results from vascular damage during fetal life, our observation sugge sts the need for investigating B19 infection in the presence of meconi um peritonitis for a better understanding of the pathogenetic potentia l of B19 parvovirus in intra-uterine infection. (C) 1998 John Wiley & Sons, Ltd.