C Wright1, S A Hinchliffe, C Taylor. 1. Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Abstract
OBJECTIVES: To study the pathological features of fetuses dying because of parvovirus B19 infection, with particular reference to the presence of hydrops; to assess the usefulness of immunochemistry as a screening method for the detection of parvovirus infection at post-mortem examination. DESIGN: Review of clinical, sonographic, serological and pathological data; immunohistochemical staining of post-mortem tissue. SAMPLE: Cases of intrauterine fetal death occurring during the 18-month period January 1993 to June 1994 inclusive, referred for post-mortem examination to the Pathology Department, Royal Victoria Infirmary, Newcastle upon Tyne. RESULTS: Eleven cases of fetal death due to parvovirus infection were identified. Seven fetuses were less than 18-week size. Three fetuses showed conspicuous hydropic change. One of the 11 cases was detected for the first time by retrospective immunochemical screening. Of cases originating from the Newcastle district, parvovirus infection was responsible for about 10% of all non-malformed fetal deaths occurring between 10 and 24 weeks of gestation referred for pathological examination. CONCLUSIONS: During the period of study, parvovirus infection was a relatively common cause of mid-trimester fetal death. Many fetuses dying because of this infection are not noticeably hydropic, and the possibility of parvovirus infection should be considered in any case of intrauterine fetal death. Immunochemistry can be used to confirm the histopathological diagnosis, and may be of particular help where there is advanced autolysis; immunohistochemical screening may detect occasional cases not initially identified by examination of routinely stained tissue sections.
OBJECTIVES: To study the pathological features of fetuses dying because of parvovirus B19 infection, with particular reference to the presence of hydrops; to assess the usefulness of immunochemistry as a screening method for the detection of parvovirus infection at post-mortem examination. DESIGN: Review of clinical, sonographic, serological and pathological data; immunohistochemical staining of post-mortem tissue. SAMPLE: Cases of intrauterine fetal death occurring during the 18-month period January 1993 to June 1994 inclusive, referred for post-mortem examination to the Pathology Department, Royal Victoria Infirmary, Newcastle upon Tyne. RESULTS: Eleven cases of fetal death due to parvovirus infection were identified. Seven fetuses were less than 18-week size. Three fetuses showed conspicuous hydropic change. One of the 11 cases was detected for the first time by retrospective immunochemical screening. Of cases originating from the Newcastle district, parvovirus infection was responsible for about 10% of all non-malformed fetal deaths occurring between 10 and 24 weeks of gestation referred for pathological examination. CONCLUSIONS: During the period of study, parvovirus infection was a relatively common cause of mid-trimester fetal death. Many fetuses dying because of this infection are not noticeably hydropic, and the possibility of parvovirus infection should be considered in any case of intrauterine fetal death. Immunochemistry can be used to confirm the histopathological diagnosis, and may be of particular help where there is advanced autolysis; immunohistochemical screening may detect occasional cases not initially identified by examination of routinely stained tissue sections.
Authors: R F Lamont; J D Sobel; E Vaisbuch; J P Kusanovic; S Mazaki-Tovi; S K Kim; N Uldbjerg; R Romero Journal: BJOG Date: 2010-10-13 Impact factor: 6.531