Lee Rachel, Garry David, Herrera Kimberly, Choi Jennifer, Heiselman Cassandra, Bernasko James, Gonsalves Zenobia, Stetler Emily, Yang Tiffany, Garduno Elizabeth, Avila Cecilia
Department of Maternal Fetal Medicine, Stony Brook University Hospital, Stony Brook, NY, USA.
Department of Obstetrics and Gynecology, Stony Brook University Hospital, Stony Brook, NY, USA.
Case Rep Perinat Med. 2025 Sep 11;14(1):20250010. doi: 10.1515/crpm-2025-0010. eCollection 2025 Jan.
Intravenous immunoglobulin (IVIG) in pregnancy has been used to treat hematologic conditions, but there is limited literature on its use in acute Parvovirus B19 infection. The purpose of this report is to highlight IVIG treatment recommendations based on low reticulocyte counts and high middle cerebral artery peak systolic velocity (MCA-PSV) values to prevent fetal hydrops, as well as identify which patients would benefit from high-dose IVIG administration in the setting of acute Parvovirus B19 infection in the second trimester.
We present the treatment of acute Parvovirus B19 infection with IVIG in two affected pregnancies, as an alternative to percutaneous umbilical blood sampling (PUBS) and intrauterine transfusion (IUT).
IVIG may be useful for Parvovirus B19 treatment in patients with erythropoietic suppression, in patients who decline PUBS/IUT with elevated MCA-PSV, and in patients who have difficult access to the placental cord insertion site, unsuccessful attempt at PUBS, or relative contraindications (i.e. significant abdominal surgery, high BMI).
孕期静脉注射免疫球蛋白（IVIG）已被用于治疗血液系统疾病，但关于其在急性B19细小病毒感染中的应用的文献有限。本报告的目的是强调基于低网织红细胞计数和高中脑动脉收缩期峰值速度（MCA-PSV）值的IVIG治疗建议，以预防胎儿水肿，并确定哪些患者在孕中期急性B19细小病毒感染的情况下将从高剂量IVIG给药中获益。
我们介绍了在两例受影响的妊娠中用IVIG治疗急性B19细小病毒感染的情况，作为经皮脐血采样（PUBS）和宫内输血（IUT）的替代方法。
IVIG可能对红细胞生成受抑制的患者、因MCA-PSV升高而拒绝PUBS/IUT的患者以及难以接近胎盘脐带插入部位、PUBS尝试不成功或有相对禁忌症（即重大腹部手术、高BMI）的患者的B19细小病毒治疗有用。
