Clinical and laboratory diagnosis and outcomes of parvovirus-induced nonimmune hydrops fetalis


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Abstract

Objective. To analyze the laboratory criteria and clinical and epidemiological features of parvovirus-induced nonimmune hydrops fetalis (NIHF) in the Republic of Belarus. Materials and methods. In the period 2012-2018, a total of51 cases of NIHF were investigated to establish the role of primate erythroparvovirus 1 (B19P), formerly known as parvovirus B19, in the occurrence of the disease; and laboratory-verified cases of parvovirus-induced infection underwent epidemiological analysis. Results. Parvovirus infection was confirmed in 12 (23.5%) cases of NIHF; the average long-term incidence rate was 1.5per 100,000 newborn infants. The main diagnostic method was the detection of B19P DNA in the serum of pregnant women and in different types of fetal biological material. Specific IgM was detected in 5 (41.6%) women and in none of the neonates. None of the women had episodes of acute exanthema during pregnancy. Hydrops fetalis was detected by ultrasound screening in 8 out of 12 cases and by ultrasonography in the remaining 4 cases due to the worse health of a pregnant woman or to the appearance of fetal arrhythmia. The main manifestations of hydrops were subcutaneous edema (83.3%), ascites (75.0%), hydrothorax (58.3%), and hydropericardium (58.3%). Parvovirus infection caused death in 7 (58.3%) cases: in 5 fetuses and 2 neonates. Conclusion. Parvovirus infection is a significant cause of NIHF and requires that molecular assays should be used to verify the diagnosis. In most cases, parvovirus-induced hydrops fetalis has an unfavorable outcome.

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About the authors

Marina A. Yermolovich

Republican Research and Practical Center for Epidemiology and Microbiology

Email: yermalovich@mail.ru
Minsk, Republic of Belarus

Marina V. Artyushevskaya

Belarusian Medical Academy of Postgraduate Education

Email: 6579542@bk.ru
Minsk, Republic of Belarus

Ekaterina Yu. Leonova

6th City Clinical Hospital

Email: katrina_pearl@rambler.ru
Minsk, Republic of Belarus

Elena O. Samoilovich

Republican Research and Practical Center for Epidemiology and Microbiology

Email: esamoilovich@gmail.com
Minsk, Republic of Belarus

Maxim V. Beluga

Republican Research and Practical Center «Mother and Child»

Email: belfetus@gmail.com
Minsk, Republic of Belarus

Olga V. Kozlyakova

6th City Clinical Hospital

Email: olga-kozlyakova@yandex.by
Minsk, Republic of Belarus

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