Clinical and virological aspects of human parvovirus B19 Infection during Gestation.

Leiden Repository

Clinical and virological aspects of human parvovirus B19 Infection during Gestation.

Type: Doctoral Thesis
Title: Clinical and virological aspects of human parvovirus B19 Infection during Gestation.
Author: Haan, Timo Robert de
Publisher: Departments of Neonatology, Obstetrics and Microbiology/ Virology, Medicine / Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2007-11-13
Keywords: Congenital
Immune response
Parvovirus B19
Viral load
Abstract: Congenital Human Parvovirus B19 (B19V) infection can lead to life threatening fetal complications as hydrops, fetal demise or severe fetal anaemia and thrombocytopenia. Maternal symptoms frequently pass unnoticed at the time of maternal infection and there was little information on the mechanism and time course of vertical transmission of B19V during gestation. Treatment consists of intrauterine fetal red blood cell and/ or platelet transfusion (IUT). The indication for treatment with IUT is set by performing fetal ultrasound screening for fetal anaemia and signs of fetal hydrops. The fetal middle cerebral artery peak systolic flow correlates well with the severity of fetal anaemia. The first two chapters of this thesis give an overview of the existing literature concerning fetal hydrops and congenital B19V infection. In the ensuing chapters we describe the course of maternal and fetal B19V infection by the B19V viral load and maternal immune response. We did not find a correlation between the fetal or maternal B19V viral load and the severity of fetal anaemia or thrombocytopenia. Thrombocytopenia is frequently encountered in congenital B19V infection, but fetal bleeding complications are not. The use of fetal platelet transfusion is therefore a matter of debate. The long- term neurodevelopment of affected fetus can be significantly delayed at a later age despite a technically correct IUT procedure. The possibility of cerebral damage due to congenital B19V infection is discussed. Parents should be counselled of these risks before the IUT procedure and long term follow -up following congenital B19V infection is advised
Description: Promotores: F.J. Walther, A.C.M. Kroes, Co-promotor: D. Oepkes
With summary in Dutch
Faculty: LUMC
Citation: Haan,, 2007, Doctoral thesis, Leiden University
ISBN: 9879090222035
Sponsor: For printing & publishing: J.E. Jurriaanse Stichting, Nederland.

Files in this item

Description Size View
application/pdf Full text 948.6Kb Under embargo
text/html Links to published articles 16.25Kb View/Open
application/pdf Cover 62.52Kb View/Open
application/pdf Title page_Table of contents 57.48Kb View/Open
application/pdf Chapter 1 69.42Kb View/Open
application/pdf Chapter 2 137.5Kb View/Open
application/pdf Chapter 3 185.0Kb View/Open
application/pdf Chapter 4 152.4Kb View/Open
application/pdf Chapter 5 105.8Kb Under embargo
application/pdf Chapter 6 97.33Kb View/Open
application/pdf Chapter 7 143.9Kb View/Open
application/pdf Chapter 8 102.6Kb Under embargo
application/pdf Chapter 9 102.7Kb View/Open
application/pdf Chapter 10 Summary_Summary in Dutch 81.66Kb View/Open
application/pdf Publications_Abstracts_Acknowledgements 53.26Kb View/Open
application/pdf Propositions 14.01Kb View/Open

This item appears in the following Collection(s)