Grand Rounds

Asymptomatic Congenital Parvovirus infection in a neonate born to an asymptomatic mother with Parvovirus infection in the third trimester - Management issues


Zahabiya Nalwalla1, Ramsha Ansari2, Tsering Yangchen Dirkhipa2, Forum Shah3, Amol Pawar4, Ira Shah2
1Perinatal Infectious Diseases Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children and Nowrosjee Wadia Maternity Hospital,, Mumbai, India, 2Perinatal Infectious Diseases Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children and Nowrosjee Wadia Maternity Hospital, Mumbai, India, 3Department of Neonatology, Nowrosjee Wadia Maternity Hospital, Mumbai, India, 4Perinatal Infectious Diseases Clinic, Department of Obstetrics and Gynaecology, Nowrosjee Wadia Hospital, Mumbai, India

Address for Correspondence: Dr. Ramsha Ansari, Flat No. 1, Noor Jahan CHS LTD, 322 S. G. Barve Marg, Kurla West, Mumbai – 400070, India. Email: ramsha97ansari@gmail.com


Keywords: Congenital Parvovirus, Fetal ventriculomegaly, PCR, Parvovirus B19

Clinical Problem:
A 29 year old primigravida (G1P1L0A0) was admitted to the hospital following a spontaneous rupture of membrane at 38 weeks of gestation. Antenatal ultrasound (USG) scan at 30+5 weeks of gestation showing mild ventriculomegaly and maternal TORCH screening showing Parvovirus B19 IgM positive and Cytomegalovirus, Rubella, Toxoplasma and Herpes Simplex Virus IgG positive. The NT-NB (nuchal translucency & nasal bone) and anomaly scan at 18 weeks of gestation were normal. She underwent spontaneous normal vaginal delivery and delivered a male child with birth weight of 2.85 kg and average for gestational age. The baby cried at birth and had an APGAR score of 8 at 1 minute and 9 at 5 minutes. On inspection, his oral, anal and nasal canals were patent, there was no evidence of cleft lip and cleft palate and he had bilaterally descended testes. On his first day of life, his hemoglobin was 20.9 g/dL, total leucocyte count was 26,110 cells/mm3 (67.2% neutrophils), platelet was 328000 cells/mm3 and reticulocyte count was 6.23%. The neonate’s Parvovirus Polymerase chain reaction (PCR) was positive and TORCH PCR was negative. USG skull was normal. The baby was on room air, hemodynamically stable and accepted feeds well.

Should this child be treated for congenital parvovirus infection?


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