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Danger to babies from “slapped face syndrome”

Tuesday October 26th, 2010

Women who develop “slapped face syndrome” in the first trimester of pregnancy are at high risk of causing serious problems for their unborn babies, researchers have warned.

A report in this week’s BJOG: An International Journal of Obstetrics and Gynaecology says that there is a 30 per cent chance of passing it onto their unborn baby, but that complications are heightened during the first three months of pregnancy.

Professor Ronnie Lamont, of the US-based National Institute of Child and Human Development, and lead author on the review, says women with weaker immune systems are particularly vulnerable, as are those who suffer from pre-existing haematological conditions.

Maternal symptoms of the virus are usually short-lived, but foetal complications include hepatitis, severe anaemia, inflammation of the heart muscle, cardiac failure and death.

Professor Lamont says that maternal infection in the first trimester is associated with a 19 per cent risk of foetal death, while a gestational age of 13-20 weeks is associated with a 15 per cent chance of foetal death. It falls to six per cent after 20 weeks.

“Slapped face syndrome” is caused by the parvovirus B19, which blocks the development of red blood cells and induces inflammation forming the characteristic facial rash.

Transmission of the virus is via respiratory droplets, such as sneezing and coughing, and the incubation period ranges from four to 14 days after exposure.

“Once diagnosed, steps should be taken to reduce the risk of onward transmission,” says Professor Lamont.

“Frequent hand washing is an effective measure and infected persons should avoid crowded areas, such as schools or shopping centres, which are likely to be frequented by pregnant women.

“All pregnant women who know they have been exposed to the virus should have a blood test to tell whether they are susceptible, and if so, whether they are developing the infection. The facial rash can often be misdiagnosed as measles or rubella so the key is to think of this virus as a possible diagnosis in such cases. A simple blood test will make the diagnosis.

“If a foetus is infected, regular ultrasound scans should be done to detect foetal anaemia and cardiac failure. Luckily if the infection occurs later than 30 weeks gestation, it is unlikely there will be any complications.”

Professor Philip Steer, BJOG editor-in-chief, said the development of a vaccine would be “extremely valuable”.

“Parvovirus B19 infection is widespread and relatively harmless for the mother, but can have serious consequences in a small percentage of babies, especially if the infection is in the first or second trimester,” he writes. “This review will help clinicians recognise the virus and raise awareness of its diagnosis and management.”

BJOG October 21 2010

Tags: Childbirth and Pregnancy | MRSA & Hygiene | North America | Women’s Health & Gynaecology

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