Pediatric and Developmental Pathology

, Volume 6, Issue 5, pp 414–420

Parvovirus Infects Cardiac Myocytes in Hydrops Fetalis


    • Department of PathologyRotunda Hospital, Dublin 1
  • Carole Barry-Kinsella
    • Department of Obstetrics and GynaecologyRotunda Hospital, Dublin 1
  • Caroline Hughes
    • Department of PathologyRotunda Hospital, Dublin 1
  • Peter Kelehan
    • Department of PathologyNational Maternity Hospital, Holles Street, Dublin 2
  • Deirdre Devaney
    • Department of PathologyRotunda Hospital, Dublin 1
  • Eoghan Mooney
    • Department of PathologyNational Maternity Hospital, Holles Street, Dublin 2
  • John Gillan
    • Department of PathologyRotunda Hospital, Dublin 1
Original Articles

DOI: 10.1007/s10024-001-0269-x

Cite this article as:
O’Malley, A., Barry-Kinsella, C., Hughes, C. et al. Pediatr. Dev. Pathol. (2003) 6: 414. doi:10.1007/s10024-001-0269-x


Parvovirus infection during pregnancy is an important cause of hydrops fetalis. It is attributed to anemia caused by viral-induced destruction of red blood cells. Infection of other organs has been reported including the heart, liver, and lungs. Few of these reports, however, convincingly demonstrate virions within the functional parenchyma of the tissue. This is of particular concern regarding myocardium in the context of hydrops fetalis which is, in part, due to cardiac failure. The problem in routine pathology practice is that most fetuses with the infection are macerated. This, in part, probably explains the paucity of published information on cardiac involvement. This study examined five cases of fatal hydrops fetalis with variable maceration with serologically proven parvovirus B19 infection. Transmission electron microscopy of cardiac tissue demonstrated intranuclear virions in both erythroid precursor cells and in cardiac myocytes in three of these cases. In each of these, immunogold electron microscopy provided confirmatory evidence of parvovirus infection. Virions were not identifiable where maceration had caused disintegration of nuclei in the myocytes. In addition, virions were absent in the three negative control cases where retroplacental hemorrhage was confirmed as the cause of death.This study suggests that parvovirus infection of cardiac myocytes may play a more important role in causing hydrops fetalis than previously realized. It also demonstrates that maceration should not discourage the use of electron microscopy.


cardiac myocyteelectron microscopyhydrops fetalisimmunohistochemistrymacerated tissueparvovirus

Copyright information

© Society for Pediatric Pathology 2003