Parvovirus-Mediated Fetal Cardiomyopathy With Atrioventricular Nodal Disease
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Acute parvovirus B19 infection (API) in pregnancy has been associated with fetal anemia and hydrops fetalis. Direct myocardial damage from API in a fetus and an infant has been described. This report presents a case of fetal second-degree heart block and cardiomyopathy secondary to API. A 19-year-old G4P1112 (gravida 4 para 2 with 1 term delivery, 1 preterm delivery, 1 termination, and 2 living children) was referred at 20 weeks gestation for fetal bradycardia. A 2:1 atrioventricular block was identified by fetal echocardiography at 23 weeks. Hydrops developed at 25 weeks. Amniocentesis and percutaneous umbilical blood sampling demonstrated API. At 31 weeks, the patient presented with preterm labor and delivered a viable female infant, who died of poor cardiac function and arrhythmia on the first day of life. In addition to fetal anemia and hydrops fetalis, API in pregnancy may cause direct fetal myocardial damage and conduction system disease.
KeywordsAtrioventricular nodal disease Fetal cardiomyopathy Fetal digoxin Parvovirus B19
Movie clip 1 Short-axis view showing bilateral ventriculomegaly, decreased cardiac function, and dyskinetic septal motion. (MOV 1622 kb)
Movie clip 2 Four-chamber view with moderate to severe mitral and tricuspid insufficiency and decreased cardiac function. (MOV 1803 kb)
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