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Antenatal diagnosis and palliative treatment of non‐immune hydrops fetalis secondary to fetal parvovirus B19 infection

Antenatal diagnosis and palliative treatment of non‐immune hydrops fetalis secondary to fetal... Hydrops fetalis was diagnosed at 22 weeks. An ultrasound examination demonstrated cardiomegaly and a fetal blood specimen obtained by cordocentesis revealed thrombocytopenia, anaemia, and neutropenia. Fetal paracentesis yielded straw‐coloured fluid with electrolytes indicative of a transudate. Non‐enveloped icosahedral viral particles approximately 23 mm in diameter were visualized in the ascitic fluid by electron microscopy. Immune electron microscopy confirmed human parvovirus B19. Direct fetal digitalization led to a reduction in umbilical artery resistance, a decline in the abdominal circumference from 20·3 to 17·8 cm, and resolution of the ascites within 72 h. Despite this dramatic response to therapy, fetal death occurred on day 5 of treatment. The initial maternal serum was positive for anti‐B19 IgM and IgG antibodies. Electron microscopy of fetal cardiac tissue obtained post‐mortem revealed intranuclear viral particles typical of B19, confirming the antenatal diagnosis of myocarditis. This case demonstrates that direct viral identification is applicable to prenatal diagnosis. To our knowledge, this is the first reported case of the antenatal diagnosis and palliative treatment of fetal viral infection. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Prenatal Diagnosis Wiley

Antenatal diagnosis and palliative treatment of non‐immune hydrops fetalis secondary to fetal parvovirus B19 infection

Prenatal Diagnosis , Volume 9 (2) – Feb 1, 1989

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References (53)

Publisher
Wiley
Copyright
Copyright © 1989 John Wiley & Sons, Ltd.
ISSN
0197-3851
eISSN
1097-0223
DOI
10.1002/pd.1970090205
Publisher site
See Article on Publisher Site

Abstract

Hydrops fetalis was diagnosed at 22 weeks. An ultrasound examination demonstrated cardiomegaly and a fetal blood specimen obtained by cordocentesis revealed thrombocytopenia, anaemia, and neutropenia. Fetal paracentesis yielded straw‐coloured fluid with electrolytes indicative of a transudate. Non‐enveloped icosahedral viral particles approximately 23 mm in diameter were visualized in the ascitic fluid by electron microscopy. Immune electron microscopy confirmed human parvovirus B19. Direct fetal digitalization led to a reduction in umbilical artery resistance, a decline in the abdominal circumference from 20·3 to 17·8 cm, and resolution of the ascites within 72 h. Despite this dramatic response to therapy, fetal death occurred on day 5 of treatment. The initial maternal serum was positive for anti‐B19 IgM and IgG antibodies. Electron microscopy of fetal cardiac tissue obtained post‐mortem revealed intranuclear viral particles typical of B19, confirming the antenatal diagnosis of myocarditis. This case demonstrates that direct viral identification is applicable to prenatal diagnosis. To our knowledge, this is the first reported case of the antenatal diagnosis and palliative treatment of fetal viral infection.

Journal

Prenatal DiagnosisWiley

Published: Feb 1, 1989

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