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Intrauterine Transfusions in Fetuses Affected by Parvovirus B19: Complications, Challenges and Outcomes
Banu Özbakir1, Emma Van den Eede2, Lone N Nørgaard3
1Division of Fetal Medicine, Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands.
Prenatal Diagnosis
|April 18, 2026
Summary
Intrauterine transfusions (IUT) for parvovirus B19 anemia are complex and have high complication rates, significantly impacting fetal survival. Centralizing care in specialized centers is crucial for better outcomes.
Area of Science:
- Maternal-fetal medicine
- Hematology
- Virology
Background:
- Parvovirus B19 infection is a significant cause of fetal anemia.
- Intrauterine transfusion (IUT) is a critical intervention for severe fetal anemia.
- The 2023-2024 epidemic necessitated evaluation of IUT for parvovirus B19-induced anemia.
Purpose of the Study:
- To evaluate procedural characteristics, complications, and outcomes of IUT for parvovirus B19-induced fetal anemia.
- To assess the impact of complications on prenatal neurological and perinatal outcomes.
- To identify factors influencing IUT success in this specific context.
Main Methods:
- Multicenter observational study across three tertiary fetal therapy centers.
- Inclusion of all fetuses undergoing IUT for confirmed parvovirus B19-induced anemia.
- Collection of maternal, fetal, and procedural data from electronic records; predefined complication criteria.
Main Results:
- 93 IUTs performed in 74 fetuses; 53% presented with hydrops fetalis.
- Technical challenges occurred in 24% and complications in 18% of procedures, higher in hydropic fetuses.
- Intracranial hemorrhage (10%) linked to lower preoperative hemoglobin; survival lower with complications (64% vs. 91%).
Conclusions:
- IUT for parvovirus B19 anemia is technically challenging with high complication rates.
- Complications significantly reduce perinatal survival, emphasizing procedural risks.
- Centralization of care in high-volume fetal medicine centers with experienced operators is recommended.
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