Emeline Maisonneuve1,2, Catherine Garel3, Stéphanie Friszer4,5, Cécile Pénager4, Bruno Carbonne6, Françoise Pernot4,5, Flore Rozenberg7, Aurélie Schnuriger8, Anne Cortey4,5, Marie-Laure Moutard9, Jean-Marie Jouannic4,5. 1. Department of Fetal Medicine, Hôpital Armand-Trousseau, Paris, France, emelinem@yahoo.com. 2. Centre National de Référence en Hémobiologie Périnatale (CNRHP), Hôpital Armand-Trousseau, Paris, France, emelinem@yahoo.com. 3. Department of Radiology, Hôpital Trousseau, Paris, France. 4. Department of Fetal Medicine, Hôpital Armand-Trousseau, Paris, France. 5. Centre National de Référence en Hémobiologie Périnatale (CNRHP), Hôpital Armand-Trousseau, Paris, France. 6. Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco, Monaco. 7. Department of Virology, Hôpital Cochin, Paris, France. 8. Department of Virology, Hôpital Armand-Trousseau, Paris, France. 9. Department of Neuropediatrics, Hôpital Armand-Trousseau, Paris, France.
Abstract
BACKGROUND: Infection with parvovirus B19 (B19V) during pregnancy may cause severe fetal anemia, hydrops, and fe tal death. Furthermore, neurodevelopmental impairment among survivors may occur despite appropriate prenatal management, including intrauterine transfusion (IUT). OBJECTIVES: Our primary objective was to describe cerebral lesions on MRI in fetuses with severe anemia requiring IUT for B19V infection. Our secondary objective was to search for clinical and biological characteristics associated with the occurrence of such lesions. STUDY DESIGN: We performed a retrospective review of data on fetuses infected with B19V and requiring at least one IUT between 2005 and 2016. Fetuses with abnormal cerebral MRI results in the 3rd trimester were compared to those with normal MRI results. RESULTS: Of 34 transfused fetuses, 26 children were born at full term. Five intrauterine fetal deaths, 1 neonatal death, and 2 terminations of pregnancy occurred. Cerebral anomalies were observed in 7/27 fetuses on MRI, including cerebellar hemorrhage or a small cerebellum. Only viral load in fetal blood appeared to be associated with brain lesions (11.5 log10 copies/mL [10.5-12.5] in case of abnormal MRI results vs. 9.5 log10 copies/mL [7.8-10.0]; p = 0.05). CONCLUSIONS: Among the fetuses transfused for B19V infection, 26% presented with prenatal abnormal cerebral imaging results. In our study, viral load in fetal blood appeared to be the only factor associated with fetal brain lesions.
BACKGROUND:Infection with parvovirus B19 (B19V) during pregnancy may cause severe fetal anemia, hydrops, and fe tal death. Furthermore, neurodevelopmental impairment among survivors may occur despite appropriate prenatal management, including intrauterine transfusion (IUT). OBJECTIVES: Our primary objective was to describe cerebral lesions on MRI in fetuses with severe anemia requiring IUT for B19V infection. Our secondary objective was to search for clinical and biological characteristics associated with the occurrence of such lesions. STUDY DESIGN: We performed a retrospective review of data on fetuses infected with B19V and requiring at least one IUT between 2005 and 2016. Fetuses with abnormal cerebral MRI results in the 3rd trimester were compared to those with normal MRI results. RESULTS: Of 34 transfused fetuses, 26 children were born at full term. Five intrauterine fetal deaths, 1 neonatal death, and 2 terminations of pregnancy occurred. Cerebral anomalies were observed in 7/27 fetuses on MRI, including cerebellar hemorrhage or a small cerebellum. Only viral load in fetal blood appeared to be associated with brain lesions (11.5 log10 copies/mL [10.5-12.5] in case of abnormal MRI results vs. 9.5 log10 copies/mL [7.8-10.0]; p = 0.05). CONCLUSIONS: Among the fetuses transfused for B19V infection, 26% presented with prenatal abnormal cerebral imaging results. In our study, viral load in fetal blood appeared to be the only factor associated with fetal brain lesions.
Authors: Maria Belen Salbetti; Mauro Sebastian Pedranti; Paula Barbero; Paula Molisani; Martina Lazzari; Nicolas Olivera; Maria Beatriz Isa; Ariel Bertoldi; Laura Moreno; Maria Pilar Adamo Journal: Access Microbiol Date: 2019-06-20