Parvovirus B19 in preg - sgillgutti

[ArchivalUser]

A pregnant woman calls the physician. She baby-sat a neighbor's child who had bright red cheeks. After searching the Internet, she is afraid that she could have a parvovirus B19 infection (B19V). Which of the following is the most appropriate action?

A. Reassure the patient that she is not at risk for B19V infection if she has not had any other exposure to the child.
B. Obtain maternal blood to determine titers of parvovirus immunoglobulin G and immunoglobulin M as well as a B19V polymerase chain reaction (PCR).
C. Immediately obtain a fetal ultrasound to evaluate for hydrops.
D. Schedule cordocentesis to evaluate fetal blood for anemia.
E. Administer oral iron, folate, and vitamin B-12 to ensure that the patient does not become anemic.

[ArchivalUser]

A
only risk when exposed before the rash appear

[ArchivalUser]

What if the lady really had an exposure to the child before the appearance of the rash?What would you do?

Is there any role of IVIG for Parvovirus in Pregnant women?

Thanks.

[ArchivalUser]

B19 symptoms begins some six days after exposure and last about a week. Infected patients with normal immune systems are contagious before becoming symptomatic, but probably not after then.

Parvovirus infection in pregnant women is associated with hydrops fetalis due to severe fetal anemia, sometimes leading to miscarriage or stillbirth. The risk of fetal loss is about 10% if infection occurs before pregnancy week 20 (esp. between weeks 14-20), but minimal after then. This risk may be reduced with correct diagnosis of the anemia (by ultrasound scans) and treatment (by blood transfusions). Once the baby is born, there is evidence to suggest no developmental abnormalities due to B19 infection during pregnancy.

[ArchivalUser]

Bijjar,

Thanks for the detailed explanation.