Revised clinical presentation of parvovirus B19-associated intrauterine fetal death

Adverse pregnancy outcome due to human parvovirus B19 (hereafter referred to as "parvovirus B19") has been characterized, in numerous reports, as an event that occurs during the first and second trimesters and is strongly associated with symptoms of fetal hydrops. Recent findings have indicated that parvovirus B19-associated intrauterine fetal death (IUFD) is also a problem in late gestation, although its clinical presentation is aberrant, lacking signs of fetal hydrops. We outlined the clinical presentation and assessed the frequency of parvovirus B19 infection in a retrospective analysis of 92 unselected cases of IUFD that occurred during or after gestational week 22. By polymerase chain reaction, parvovirus B19 DNA was detected in 13 (14%) of the 92 cases. Only 2 of the parvovirus B19 DNA-positive cases were hydropic, both representing early IUFDs. This finding indicates that parvovirus B19-associated IUFD in late gestation is a common finding and that hydropic presentation is rare. This knowledge may contribute to a reduction in the number of unexplained cases of IUFD.