Boggio Gabriel A, Moreno Laura, Di Cuatro Néstor, Colazo Salbetti María B, Pedranti Mauro, González Alicia, Grandon Claudia, Resino Carlos, Adamo María P
Chair of Pediatrics, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
Obstetrics Service, Hospital Universitario de Maternidad y Neonatología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
Arch Argent Pediatr. 2025 Jun 1;123(3):e202410420. doi: 10.5546/aap.2024-10420.eng.
Non-immune hydrops fetalis represents a diagnostic challenge in high-risk pregnant women. Vertical infection with human parvovirus B19 (B19V) is a possible cause. National guidelines propose maternal serologic screening (IgG/IgM), which may be insufficient in some situations. We report a case of vertical B19V infection with difficulties in prenatal diagnosis. Preterm newborn, normal weight (2950 g), born to a 30-year-old mother with anemia and hydrops fetalis (week 17). Cardiac, chromosomal, isoimmunization-Rh, and usual infectious causes (TORCH) were ruled out. Maternal serology for B19V showed IgG+ and IgM-, and the diagnosis was dismissed. The newborn presented abdominal distension (ascites), anemia, and jaundice. Postnatal results confirmed the diagnosis with DNA+ for B19V. Discharge at 17 days with good evolution. The protocol for B19V screening in vertical infection needs to be revised by incorporating early molecular studies (PCR) from the early stages of gestation to optimize the diagnosis and treatment of patients with this congenital infection.
非免疫性胎儿水肿对高危孕妇来说是一项诊断难题。人细小病毒B19（B19V）的垂直感染是一个可能的原因。国家指南建议进行母体血清学筛查（IgG/IgM），但在某些情况下可能并不充分。我们报告一例产前诊断困难的B19V垂直感染病例。一名早产新生儿，体重正常（2950克），其母亲为一名30岁患有贫血和胎儿水肿的孕妇（孕17周）。排除了心脏、染色体、血型不合-Rh以及常见感染原因（TORCH）。母亲的B19V血清学检查显示IgG阳性和IgM阴性，诊断被排除。新生儿出现腹胀（腹水）、贫血和黄疸。产后结果通过B19V的DNA阳性确诊。17天后出院，情况良好。垂直感染中B19V的筛查方案需要修订，应纳入妊娠早期的早期分子研究（PCR），以优化对这种先天性感染患者的诊断和治疗。
