Document Detail


First-trimester treatment of fetal anemia secondary to parvovirus B19 infection.
MedLine Citation:
PMID:  17252527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Here we report two cases of first-trimester parvovirus B19 (PV-B19) infection that were successfully treated by intrauterine blood transfusion into the umbilical vein. At 13 weeks' gestation both fetuses presented with increased nuchal translucency (NT) and cardiomegaly. In both cases pulsed Doppler ultrasound examination of the fetal middle cerebral artery (MCA) revealed increased peak systolic velocity (PSV), which led to a suspicion of fetal anemia. Maternal PV infection was confirmed by a positive polymerase chain reaction result. Each fetus received a 3-mL intravenous transfusion of packed red blood cells into the umbilical vein, using a 25-G spinal needle. Follow-up ultrasound and Doppler examination demonstrated fetal well-being, decline of the MCA-PSV and resolution of the NT. Case 1 was readmitted at 25 weeks' gestation with severe hydrops fetalis, and both mother and fetus still tested positive for PV-B19 DNA. Three more intrauterine blood transfusions were performed and the fetal hydrops resolved. In Case 2 no additional transfusions were needed. Both babies had a good neonatal outcome and uneventful follow-up. Our findings demonstrate that the MCA-PSV is helpful in establishing the diagnosis of first-trimester fetal anemia. Intravasal transfusion can be attempted as early as the first trimester.
Authors:
A Kempe; B Rösing; C Berg; D Kamil; A Heep; U Gembruch; A Geipel
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  29     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-30     Completed Date:  2007-11-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  226-8     Citation Subset:  IM    
Copyright Information:
Copyright 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Prenatal Medicine, University Hospital of Bonn, Germany. andrea.kempe@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia / therapy*,  ultrasonography,  virology
Blood Transfusion, Intrauterine / methods*
Female
Follow-Up Studies
Humans
Hydrops Fetalis / therapy*,  ultrasonography,  virology
Infectious Disease Transmission, Vertical
Parvoviridae Infections / therapy*,  transmission
Parvovirus B19, Human*
Pregnancy
Pregnancy Complications, Infectious / therapy*
Pregnancy Outcome
Pregnancy Trimester, First
Prenatal Care / methods
Treatment Outcome
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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