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Chapter 13.2 - Fetal infections

Clinical management

from Section 2 - Fetal disease

Published online by Cambridge University Press:  05 February 2013

Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
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Summary

Introduction

This chapter focuses upon pathogenic organisms that may be responsible for fetal infection during pregnancy and may have significant effects on outcome. Many infections have associated serious consequences including fetal/perinatal mortality and significant morbidity. Each of the pathogenic organisms will be discussed in turn and specific risks and morbidity outlined.

Introduction

Parvovirus B19 was discovered by chance in 1975 during a systematic search of hepatitis B surface antigen (HBsAg) in sera from blood donors. The name of B19 refers to the number of blood bag in which the virus was discovered. It was not until 1984 that its responsibility in the occurrence of fetal hydrops was proven.

Parvovirus B19 belongs to the Parvoviridae family. This is a naked virus whose genome is linear single-stranded DNA-like. Parvovirus nucleotide variability is low (<1%). After penetration through the respiratory tract, the virus replicates in the nasopharynx, viremia occurs and then a non-specific febrile syndrome appears eight days after primary infection. IgM are present and an antigen–antibody complex is formed causing the rash that appears approximately three weeks after infection in infected children. Therefore, the patient is no longer contagious because the virus is not present in the nasopharynx.

Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
, pp. 208 - 237
Publisher: Cambridge University Press
Print publication year: 2012

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