Русский
Clinical and laboratory diagnosis and outcomes of parvovirus-induced nonimmune hydrops fetalis
DOI: https://dx.doi.org/10.18565/epidem.2019.9.3.57-64
Yermolovich M.A., Artyushevskaya M.V., Leonova E.Yu., Samoilovich E.O., Beluga M.V., Kozlyakova O.V.
1) Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Republic of Belarus; 2) Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus; 3) 6th City Clinical Hospital, Minsk, Republic of Belarus; 4) Republican Research and Practical Center «Mother and Child», Minsk, Republic of Belarus
Materials and methods. In the period 2012–2018, a total of 51 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 1.5 per 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 Autors
Marina A. Yermalovich, Сand. Med. Sci., Leading Researcher, Laboratory оf Vaccine-Controlled Infections, Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Republic of Belarus; e-mail: yermalovich@mail.ru; ORCID: https://orcid.org/0000-0002-2750-4730;
Marina V. Artyushevskaya, Сand. Med. Sci., Assistant Professor, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus; e-mail: 6579542@bk.ru;
Ekaterina Yu. Leonova, Сand. Med. Sci., Neonatologist, Department of Anesthesiology and Intensive Care for Newborns, 6th City Clinical Hospital, Minsk, Republic of Belarus; e-mail: katrina_pearl@rambler.ru;
Prof. Elena O. Samoilovich, MD, Head, Laboratory оf Vaccine-Controlled Infections, Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Republic of Belarus; e-mail: esamoilovich@gmail.com;
Maxim V. Beluga, Obstetrician/Gynecologist, Researcher, Laboratory of Obstetric and Gynecological Pathology, Republican Research and Practical Center “Mother and Child”, Minsk, Republic of Belarus; e-mail: belfetus@ gmail.com;
Olga V. Kozlyakova, Сand. Med. Sci., Head, Department of Obstetric Immunohematology, City Center of Transfusiology, 6th City Clinical Hospital, Minsk, Republic of Belarus; e-mail: olga-kozlyakova@yandex.by.
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