Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.18/1326
Título: Suspected Cases of Parvovirus B19 Infection During Pregnancy: A Retrospective Analysis (2009-2012)
Autor: Lopo, Silvia
Reis, Tânia
Palminha, Paula
Palavras-chave: Parvovirus B19
Infection During Pregnancy
Epidemiologia Clínica
Perturbações do Desenvolvimento Infantil e Saúde
Infecções Sistémicas e Zoonoses
Data: Set-2012
Editora: Instituto Nacional de Saúde Doutor Ricardo Jorge, IP
Resumo: INTRODUCTION Parvovirus B19 (B19V) infection in pregnancy may cause serious damage to the foetus, where infection of placental endothelial cells can lead to hydrops fetalis and/or intrauterine fetal death. In Portugal, B19V female prevalence rates increases with age, reaching about 54.60% between age 20 and 24, 63.8% between age 25 and 29, 64.6% between age 30 an 34 and increasing up to 82.7% in the elder people. After maternal infection, transplacental transmission can occur at different rates depending on gestational ages. The virus is not teratogenic, but congenital infection may be associated to serious birth defects. OBJECTIVES To study suspected cases of B19V infection during pregnancy between May 2009 – May 2012, according to epidemiological, laboratory and clinical data, based on a retrospective study at the National Institute of Health (NIH) in Lisbon. METHODS Thirty-one amniotic fluid samples of 31 pregnant women (median age 29.7 years old) obtained between weeks 13 and 36 of gestation, were analysed at the NIH, according to the clinic indication of maternal cutaneous rash (2 cases), fetal dead (3 cases at 13, 21 and 33 weeks of pregnancy) or fetal ultrasonographic abnormalities (26 cases). B19V-DNA was determined by a ready-to-use commercial real-time PCR system, with a specific amplification of a 76 bp region of the B19V genome. RESULTS B19V DNA were detected in 3/31 amniotic fluid samples (9.7%), all of them with previous clinical diagnosis of hydrops fetalis at 21, 23 e 25 weeks of gestation. From the 26 cases with fetal ultrasonographic abnormalities, 10 cases were not specified, 8 cases had clinical diagnosis of hydrops fetalis and the remaining 8 were other specific abnormalities. One positive case result in fetal death and other positive case result in fetal death after intrauterine blood transfusion. One case resolved after intrauterine blood transfusion, without sequelae. CONCLUSIONS B19V infection is an important health issue since is the most common cause of nonimmune hydrops fetalis and can result in fetal death in 2-6% of cases A total of 3 patients (9.7%) were tested positive for B19V infection in amniotic fluid. According to our results and previous literature, the risk of developing fetal hydrops is high and the risk of fetal dead when maternal infection occurs in the first 20 weeks of pregnancy. Fetal ultrasonography was useful in detecting hydrops and real-time PCR technique in amniotic fluid has been shown to be a good methodology in cases of clinical suspicion of active B19V infection. These results are not representative of all suspected cases of B19V infection during pregnancy in Portugal. Preconceptional screening or prophylactic interventions are not presently recommended. Considering that as many as 36% of women may not be immune to B19V and are susceptible to infection, PCR technologies for DNA detection of B19V in amniotic fluid with increased sensitivity level, are an important diagnostic tool and an aid to confirm clinic B19V diagnostic.
URI: http://hdl.handle.net/10400.18/1326
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