OBJECTIVETo characterize the risks and histopathological features of parvovirus B19 infection of infants in perinatal period.

METHODSRoutine pathological examination was performed on 1 neonate, 2 dead fetuses and 2 placentas using either autopsy or biopsy materials.

RESULTSThe diagnostic intranuclear inclusions were found in erythroblasts in the bone marrow, liver, spleen and lungs in one case, in the spleen and liver in one case, in the spleen in one case, and in the placentas in two cases.

CONCLUSIONSSevere hemolytic anemia or fetal hydrop or hemophagocytosis caused by the infection of parvovirus B19 can lead to death of infected neonates and fetus. Pathological confirmation of parvovirus B19 infection relies on the identification of erythroblasts containing the diagnostic intranuclear inclusions.

Anemia ; pathology ; virology ; Autopsy ; Biopsy ; Erythema Infectiosum ; blood ; pathology ; virology ; Erythroblasts ; ultrastructure ; Female ; Fetal Death ; Fetus ; Humans ; Hydrops Fetalis ; pathology ; virology ; Inclusion Bodies ; ultrastructure ; Infant, Newborn ; Lymphohistiocytosis, Hemophagocytic ; pathology ; virology ; Parvovirus B19, Human ; isolation & purification ; Placenta ; pathology ; virology ; Pregnancy ; Stillbirth

OBJECTIVESTo analyze the relationship between the fetus infection and HBV M, HBV DNA in amniotic fluid, umbilical cord blood, maternal blood and placenta, and to explore the mechanism of vertical transmission of HBV.

METHODSImmunonetric assay and nucleic acid amplification hybri-comb were used. Both HBV M and HBV DNA were detected in amniotic fluid, vein blood, umbilical cord blood for each of 65 HBV-positive women in their different gestational periods, while immunohistochemical analysis was carried out on the tissue of placenta, liver, lung or heart from each abortive fetus/dead infant in the case.

RESULTSFor all of the 65 HBsAg-positive women in their different gestational periods, the detected positive rate of HBsAg was 21.50% in amniotic fluid, and 20.00% in umbilical blood. The positive rate of HBsAg, HBeAg, Anti-HBc and HBV DNA detected in blood, amniotic fluid and umbilical blood was 6.15%. The cases with positive HBsAg, Anti-HBe, Anti-HBc and negative HBV DNA were in a percentage of 13.85%. Immunohistochemical analysis on placentas after birth/abortion as well as the tissues of livers, lungs, hearts of the fetuses/dead infants in 4 cases of pregnant women with positive HBsAg, HBeAg, Anti-HBc or HBV DNA in blood, amniotic fluid or umbilical blood showed that HBsAg, HBcAg positive cells in the scope could be seen in every layer of the tissue of placenta, in the hepatic/pulmonary tissue, but not in the cardiac tissue.

CONCLUSIONThe infection in amniotic fluid or placenta relates to HBV infection in fetus; intrauterine HBV may result in infection in organs such as blood, liver, or lung of a fetus; infection in the amniotic fluid may be another key route of the intrauterine infection of fetus, and the detection on HBV M or HBV DNA in amniotic may be used as one of diagnostic proofs of HBV infection of fetus in its early stage.

Adult ; Amniotic Fluid ; virology ; DNA, Viral ; analysis ; Female ; Hepatitis B ; diagnosis ; transmission ; Humans ; Immunohistochemistry ; Infectious Disease Transmission, Vertical ; Placenta ; virology ; Pregnancy ; Pregnancy Complications, Infectious ; diagnosis

A new nested-polymerase chain reaction (nested-PCR) assay was developed to detect human parvovirus B19 DNA corresponding to the nonstructural protein in clinical specimens in a routine diagnostic laboratory. The sensitivity of this highly specific assay was up to 0.005 fg of B19 DNA. Parvovirus B19 was identified in sera of 20 pregnant women with abnormal pregnant outcome. Among these 20 cases, intrauterine parvovirus infection did exist in 7 pregnant women because parvovirus B19 DNA was detected in the pregnant tissues of them such as placenta tissues, chorionic villi, amniotic fluid, fetal spleen, liver and abdominal fluids.
DNA, Viral/*analysis ; Parvoviridae Infections/*virology ; Parvovirus B19, Human/genetics ; Parvovirus B19, Human/*isolation & purification ; Placenta/virology ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/*virology ; Viral Nonstructural Proteins/*analysis

PURPOSE: This study investigated the possible relationship between viral infection and first trimester pregnancy loss. MATERIALS AND METHODS: A prospective study was performed on 51 gravidas with missed abortion, fetal anomaly, pre-term delivery, and full-tem delivery at Hanyang University Hospital. Enteroviruses were detected by semi-nested reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry in abortive tissues and placentas. Enterovirus serotypes were confirmed by genome sequencing. Herpesviruses were detected by PCR. RESULTS: Coxsackievirus B3 (CVB3) was detected in 8 of 14 missed abortion cases, 1 of 27 full-term cases, and none of the 9 pre-term cases. Coxsackievirus B1 (CVB1) was detected in an encephalocele case. Herpes simplex virus type 1 was found in 4 full-term cases, 3 pre-term cases, and none of the missed abortion cases. CONCLUSION: The prevalence of CVB3 was significantly higher in missed abortion cases compared to full-term or pre-term delivery cases. CVB infection may therefore be an important etiological agent of missed abortion.
Abortion, Missed/*etiology ; Adult ; Coxsackievirus Infections/complications/*diagnosis/virology ; Enterovirus B, Human/genetics/*isolation & purification ; Female ; Humans ; Immunohistochemistry ; Placenta/virology ; Pregnancy ; Pregnancy Complications, Infectious/*virology ; Pregnancy Trimester, First ; Prevalence ; Prospective Studies ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Uterus/*virology

OBJECTIVETo evaluate the effects of Jinye Baidu Granule ( JYBDG), a traditional Chinese medicine compound prescription, on fetal growth and development with maternal active human cytomegalovirus infection.

METHODSA prospective, randomized and controlled trial was adopted during January 1996 to June 2002. From the pregnant women with an abnormal pregnant history, 240 cases were screened to be infected by human cytomegalovirus (HCMV) by enzyme-linked immunoabsorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR). They were assigned according to the random number table to two groups. The 122 cases in the treatment group were administrated with JYBDG, one package each time, three times a day for two continuous weeks, while the other 118 in the control group did not receive any treatment. The negative conversion rate of both HCMV-IgM and HCMV late mRNA, the positive rate of HCMV-DNA in placenta and the intrauterine transmission rate between the two groups were compared, and fetal growth and development in partial fetuses were also observed.

RESULTSThe negative conversion rate of both HCMV-lgM and HCMV late mRNA, the positive rate of HCMV-DNA in placenta and the intrauterine transmission rate in the treatment group were 77. 05% (94/122), 48. 98% (48/98) and 21.74% (10/46) respectively, while those in the control group were 38. 14% (45/118), 67.50% (54/80) and 52.63% (20/38) respectively, all showing significant difference between the two groups (P<0. 01). Totally 35 normal infants and 11 abnormal infants were born in the treatment group, and the number in the control group was 20 and 18 respectively, and comparison between the two groups showed significant difference (P<0.01). Six months of child birth, the scores of both mental development index (MDI) and psychomotor development index (PDI) of infants were higher in the treatment group (20 cases) than those in the control group (20 cases), but there was no significant difference between the two groups (P>0.05).

CONCLUSIONJYBDG could decrease the intrauterine transmission of HCMV and is beneficial to fetal growth and development.

Adult ; Antibodies, Viral ; blood ; Cytomegalovirus Infections ; drug therapy ; DNA, Viral ; analysis ; Female ; Fetal Development ; drug effects ; Humans ; Immunoglobulin M ; blood ; Medicine, Chinese Traditional ; Placenta ; virology ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Prospective Studies

INTRODUCTION: Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore. METHODS: Prospective observational study of 16 pregnant patients admitted for COVID-19 to 4 tertiary hospitals in Singapore. Outcomes included severe disease, pregnancy loss, and vertical and horizontal transmission. RESULTS: Of the 16 patients, 37.5%, 43.8% and 18.7% were infected in the first, second and third trimesters, respectively. Two gravidas aged ≥35 years (12.5%) developed severe pneumonia; one patient (body mass index 32.9kg/m2) required transfer to intensive care. The median duration of acute infection was 19 days; one patient remained reverse transcription polymerase chain reaction (RT-PCR) positive >11 weeks from diagnosis. There were no maternal mortalities. Five pregnancies produced term live-births while 2 spontaneous miscarriages occurred at 11 and 23 weeks. RT-PCR of breast milk and maternal and neonatal samples taken at birth were negative; placenta and cord histology showed non-specific inflammation; and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunoglobulins were elevated in paired maternal and umbilical cord blood (n=5). CONCLUSION The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
Abortion, Spontaneous/epidemiology* ; Adult ; COVID-19/transmission* ; COVID-19 Nucleic Acid Testing ; COVID-19 Serological Testing ; Cohort Studies ; Disease Transmission, Infectious/statistics & numerical data* ; Female ; Fetal Blood/immunology* ; Humans ; Infectious Disease Transmission, Vertical/statistics & numerical data* ; Live Birth/epidemiology* ; Maternal Age ; Milk, Human/virology* ; Obesity, Maternal/epidemiology* ; Placenta/pathology* ; Pregnancy ; Pregnancy Complications, Infectious/physiopathology* ; Pregnancy Outcome/epidemiology* ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prospective Studies ; RNA, Viral/analysis* ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Singapore/epidemiology* ; Umbilical Cord/pathology* ; Young Adult