Congenital parvovirus B19 infection: Experience of a recent epidemic

Objective: We report the management and outcome of 6 cases of non-immune fe tal hydrops secondary to parvovirus B19 infection presenting over a 5-month period. Methods: The Queen Mothers Hospital is a tertiary referral centre for fetal medicine. All cases were suspected on the basis of ultrasound evi dence of hydrops, Two cases were managed conservatively owing to the presen ce of an active fetus with evidence of resolving hydrops. Fetal blood sampl ing intra-uterine transfusion and drainage of ascitic fluid were performed in 3 cases. The 6th case unfortunately resulted in an intra-uterine death p rior to fetal blood sampling. Results: Maternal parvovirus specific B19 was identified in all cases. Fetal parvovirus B19 IgM was identified in the 3 cases in whom fetal blood sampling was performed. A single intra-uterine tr ansfusion was performed in these 3 cases; fetal hydrops resolved in 2 of th ese pregnancies progressing to the birth of a healthy baby at term, whereas 1 case was complicated by intra-uterine death. Fetal hydrops resolved in b oth cases managed conservatively, leading to the birth of a healthy baby at term. Conclusions: Parvovirus B19 infection should always be suspected in cases of non-immune hydrops. Conservative management will be appropriate in some cases and should involve weekly ultrasonography, The outlook for preg nancies presenting with gross hydrops remains guarded, even if intra-uterin e transfusion is performed successfully. Copyright (C) 2001 S. Karger AG, B asel.