Non immune hydrops fetalis due to Parvovirus B19 infection. A case report

Abstract

Backround: The term “hydrops fetalis” refers to excessive accumulation of pathologic serous fluid within the fetal soft tissues and body cavities. There are two categories, the immune and the nonimmune hydrops (NIHF). Currently 90 percent of cases of hydrops are nonimmune, because of the decrease of incidence of immune with the advent of anti-D immune globulin. Case presentation: We present a case of Parvovirus B19 (PB19) infection that resulted in NIHF. Fetus had severe ascites, mild pericardial effusion and mild myocardial dilation, that appeared during the 30th gestational week. Fetal evaluation with sonography was repeated every week and the fetal growth curves, Dopplers and amniotic fluid index were normal. Each week there was a gradual recession of the effusions until the 36th gestational week, when they eventually resolved without any treatment. After delivery, the neonate was symptom – free. Conclusions: The cause of NIHF is identified in at least 60 percent prenatally and in more than 80 percent postnatally, while only 40 percent of pregnancies with NIHF result in a liveborn neonate. The prognosis is heavily dependent on etiology. Diaplacental transmission of PB19 on second trimester can cause fetal complications like hydrops, premature rapture of membranes, even fetal loss in about 30 percent. These cases should be closely followed in a Fetal Medicine Unit, especially if there is evidence of fetal anemia or hydrops.