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Parvovirus B19 infection in pregnancy

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of parvovirus B19 infection in pregnancy are prepared by our editorial team based on guidelines from the American College of Obstetricians and Gynecologists (ACOG 2015) and the Society of Obstetricians and Gynaecologists of Canada (SOGC 2014).
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Screening and diagnosis

Indications for screening: as per SOGC 2014 guidelines, do not obtain routine screening for parvovirus B19 immunity in low-risk pregnancies.
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Diagnostic investigations

Serologic testing: as per SOGC 2014 guidelines, obtain serologic testing to determine susceptibility to infection (non-immune) or a current infection (parvovirus B19 IgG and IgM) in pregnant females exposed to, or developing symptoms of, parvovirus B19 infection.
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Patient education

General counseling
As per SOGC 2014 guidelines:
Advise pregnant patients non-immune to parvovirus B19 to minimize exposure at work and at home. Consider advising absence from work on a case-by-case basis.
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Counsel pregnant patients with a recent diagnosis of parvovirus B19 regarding risks of fetal transmission, fetal loss, and hydrops.
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Follow-up and surveillance

Indications for referral
As per SOGC 2014 guidelines:
Consider referring pregnant patients with a recent diagnosis of parvovirus B19 infection to an obstetrician or a maternal-fetal medicine specialist.
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Refer patients with hydrops fetalis or evidence of fetal anemia to a specialist capable of fetal blood sampling and intravascular transfusion.
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