The Obstetrician & Gynaecologist 2009;11:2:108-116
doi: 10.1576/toag.11.2.108.27484
Copyright © 2009 by the Royal College of Obstetricians and Gynaecologists.
Prenatal diagnosis and management of fetal infections
Meekai To, MD MRCOG, Consultant in Fetal Medicine1,
Michael Kidd, MSc PhD FRCPath, Consultant Clinical Scientist and Honorary Senior Lecturer2 and
Darryl Maxwell, MD FRCOG, Consultant in Fetal Medicine and Director of Fetal Medicine Unit3
1. Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, Denmark Hill, London SE5 8RX, UK Email: meekai.to{at}kch.nhs.uk (corresponding author)
2. Department of Virology, University College London Hospitals NHS Foundation Trust, Level 5, Windeyer Building, Cleveland Street, London W1T 4JF, UK
3. Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Key content:
- The risks of transplacental transmission and fetal damage are pathogen- and gestation-specific.
- Amniocentesis is the mainstay of diagnosis of fetal infection.
- Ultrasound surveillance is the primary tool for the detection of an affected fetus.
- Therapeutic options are restricted to intrauterine blood transfusion in parvovirus infection and maternal antibiotic therapy in toxoplasmosis infection.
Learning objectives:
- To gain an overview of prenatal diagnosis of the commonest congenital infections.
- To appreciate that optimal care involves a multidisciplinary approach.
Ethical issues:
- Detection of virus alone is not synonymous with fetal damage; a negative result does not completely exclude the possibility of fetal infection.
- Presence or absence of sonographic markers of fetal infection may not accurately predict long-term outcome.
Please cite this article as: To M, Kidd M, Maxwell D. Prenatal diagnosis and management of fetal infections. The Obstetrician & Gynaecologist 2009;11:108–116.
Keywords cytomegalovirus / human parvovirus B19 / toxoplasma gondii / rubella / varicella-zoster
Copyright © 2009 by the Royal College of Obstetricians and Gynaecologists.
