Fetal thrombocytopenia secondary to parvovirus infection

Am J Obstet Gynecol. 2007 Jan;196(1):61.e1-4. doi: 10.1016/j.ajog.2006.08.041.

Abstract

Objective: The aim of this study was to determine the platelet count in fetuses undergoing cordocentesis for hydrops caused by parvovirus infection.

Study design: Fetal platelets were measured at cordocentesis in 11 pregnant women who underwent the procedure because of fetal ascites and/or hydrops caused by parvovirus infection. Thrombocytopenia was defined as mild (platelet count < 150 x 10(9)/L), moderate (platelet count < or = 100 x 10(9)/L), or severe (platelet count to < or = 50 x 10(9)/L). Paired Student t test was performed to compare the platelet count before and after the transfusion.

Results: The fetuses underwent 20 cordocenteses. They were thrombocytopenic in 17 and anemic in 15 occasions. The platelet count was reduced after the transfusion (P < .05). Demises occurred after the first transfusion in 2 fetuses. The first occurred within 5 minutes from the procedure and the second within 24 hours. Both were attributed to exsanguination from the umbilical cord puncture site (platelet count 2 and 24 x 10(9)/L, respectively).

Conclusion: Thrombocytopenia is common in fetuses with hydrops caused by parvovirus infection, and can cause exsanguination from the umbilical cord puncture site. We recommend platelet transfusion during cordocentesis when there is severe thrombocytopenia.

MeSH terms

  • Cordocentesis
  • Fetal Diseases / blood*
  • Fetal Diseases / virology*
  • Humans
  • Parvoviridae Infections / blood*
  • Platelet Count
  • Thrombocytopenia / blood*
  • Thrombocytopenia / virology*