Developing parvovirus B19 during pregnancy is of special concern since it affects both the mother and her unborn child. There is no specific treatment or prophylaxis for the infection but close monitoring and expert prenatal care can reduce the rate of mortality.
What is parvovirus B19?
Parvovirus B19 (Fifth disease or ‘red rash’ during childhood is one expression of the B19 virus) inhibits the production of red blood cells. While this might not be an issue for healthy adults and children, individuals with chronic anemia (specifically conditions such as sickle cell disease) or immune deficiency can have serious problems. When contracted during pregnancy it has been known to affect a small number of fetuses.
How do you contract the parvovirus?
- Through saliva and nasal secretions
- Being near an infected person who coughs or sneezes
- Sharing eating utensils or drinking glasses
- Hand-to-mouth contact
How does parvovirus B19 affect your pregnancy?
Since parvovirus can also be transmitted through the blood there is a chance that you may pass it on to your baby during pregnancy. This may cause several complications including:
- Stillbirth/spontaneous abortion
- Fetal anemia
- Congenital abnormalities - central nervous system, craniofacial and eye anomalies
- Heart inflammation in the baby, which when severe can lead to a potentially fatal condition called hydrops fetalis (excess fluid in the baby's tissue)
You should be aware, however, that there is a 30 to 50 percent chance that you have already had fifth disease and are therefore immune to the B19 virus. This reduces the risk of being infected and passing it on to your baby. The risk of adverse fetal outcome is increased if maternal infection occurs during the first two trimesters of pregnancy, but it may also happen during the third trimester.
What are the symptoms of parvovirus?
Symptoms begin some six days after exposure (between 4 and 28 days, with the average being 16 to 17 days) and last about a week. Some signs of infection include:
- Low-grade fever
- Runny nose
- Sore throat
Parvovirus symptoms can vary from person to person and some infected individuals may have none at all. However, they are still contagious.
How can I avoid getting infected?
It may be difficult to determine if an individual has been infected (and is contagious) since many exhibit no symptoms. There are some general precautions you can take to reduce the risk of being infected.
- Keep away from people with viral-like symptoms
- Wash your hands often, and always after wiping noses or touching the tissue paper used by kids who are sick or who have been around others who are sick
- Don't share food, eating utensils, or drinking glasses
How is the parvovirus diagnosed?
- Blood test: You will be asked to do a blood test that checks for parvovirus antibodies. This helps determine whether you're immune, have been recently infected, or at risk for the infection. The doctor may also ask you to repeat the blood test if he/she suspects you still have the virus.
- Ultrasound: If you are infected, the doctor may recommend that you do a series of ultrasounds to check for:
- Excess fluid in your baby's tissue (hydrops fetalis)
- Too much amniotic fluid
- A placenta that looks overly large and swollen
- Your baby’s blood flow and signs of fetal anemia (Doppler sonography)
- Percutaneous umbilical blood sampling: This is recommended when prenatal testing shows evidence of anemia or fetal hydrops. In this procedure, a perinatologist (a high-risk pregnancy specialist) inserts a needle into your uterus under ultrasound guidance and draws blood from your baby's cord to test for anemia. If there is severe anemia, she may then recommend a fetal transfusion, in which blood is transfused into your baby's umbilical cord vein.
Most women with the parvovirus B19 infection in pregnancy have a satisfactory outcome. There is, however, an increased risk of fetal loss and non-immune hydrops in the second trimester. Early diagnosis and specialized care can increase your chances of positive results.
Dr. Jorge L. Gomez earned his Medical Degree in 1990 at Central Del Caribe University in Bayamon, Puerto Rico. Following residency in Obstetrics and Gynecology at Bronx-Lebanon Hospital center in the Bronx, NY (1990–1994), he completed additional fellowship training at New York University Medical Center NY, specializing in Maternal Fetal Medicine (1994-1996). After his fellowship in 1996 he joined South Florida Perinatal Medicine. Dr. Gomez is Board certified in OBGYN and Maternal Fetal Medicine. From 2003–2007 He was a reviewer for the American Journal Of Obstetrics and Gynecology.