Signs, Causes, And Treatment For Fifth Disease In Pregnancy

Fifth disease in pregnancy is a rare skin rash affecting around one in 400 pregnant women (1). It is also known as erythema infectiosum and is caused by parvovirus B19 and transmitted through direct contact, sneezing, coughing, and bodily fluids. The disease derived its name from a list of historical classification of common rash diseases in children, in which it was in the fifth position.

Most women are immune to the disease due to previous exposure and exhibit mild symptoms. Usually, the chances of the babies being affected are relatively low (2).

Read this post to learn about fifth disease during pregnancy and how to manage the infection.

Signs Of Fifth Disease During Pregnancy

Some of the common signs and symptoms that might develop in affected pregnant women are (1), (3):

• Sore throat
• Red eyes
• Fever
• Malaise or a general feeling of discomfort
• Headache
• Joint pains
• Facial rashes

Causes And Risk Factors Of Fifth Disease In Pregnancy

Typically, a respiratory infection of parvovirus B19 causes fifth disease during pregnancy (4). The viral carrier of the disease can spread rapidly, similar to a common cold.

Some risk factors for fifth disease infection during pregnancy are (1), (5):

• Primary contacts: It is an infectious disease that quickly spreads from touching, coughing, sneezing, and bodily fluids. Pregnant women working as healthcare workers or teachers require close contact with the infected patients.
• Weak immune system: Women with low immunity are at higher risk for the disease. They are also the most common carriers for the disease.

Complications Of Fifth Disease During Pregnancy

Fifth disease has mild symptoms, but in rare cases, it can cause severe complications. Some of the complications associated with pregnant women are (1), (4), (6):

• Severe anemia: Pregnant women with fifth disease are prone to severe anemia, and require a blood transfusion.
• Arthritis: Severe joint pain is a common complaint among pregnant women with the fifth disease infection.
• Vertical transfer: A mother can pass the disease to her baby during pregnancy. There are about 17-33% chances for vertical transmission, and some of the complications from the infection to the fetus are (4):
• Fetal anemia
• Non-immune hydrops (NIH)
• Abortion
• Stillbirth
• Miscarriage

Diagnosis Of Fifth Disease During Pregnancy

Since the disease has mild symptoms, it becomes difficult to notice the signs. Following listed are some diagnostics tests to diagnose fifth disease during pregnancies (3), (4), (7), (8):

• Serological blood tests can show immunity from previous and recent signs of parvovirus B19 infection. After a recent illness, the blood samples will show the presence of parvovirus B19 IgM and IgG antibodies.
• A fetal amniotic fluid or cord blood can be analyzed to diagnose if the infection has passed to the fetus. A polymerase chain reaction (PCR) test of the fetal amniotic fluid will tell about the presence of parvovirus B19 DNA.
• A weekly ultrasound for up to 10-21 weeks can help diagnose developing fetal anemia or hydrops.

Treatment Of Fifth Disease

Often, an infection of fifth disease goes away untreated. However, some complications might require treatment to manage the disease (3):

• Anemia is often treated by blood transfusion.
• Persistent parvovirus B19 infections are treated with immunoglobulin infusion.
• In case of severe fetal anemia, intrauterine transfusion of blood is done through the umbilical cord.
• For joint and muscle pains, nonsteroidal anti-inflammatory drugs, and acetaminophen are used.

Measures To Prevent Fifth Disease During Pregnancy

Some preventive measures you may follow during pregnancy are (8):

• Getting tested for the parvovirus B19 infection if:
• You come in contact with a parvovirus B19 infected patient.
• You are immunocompromised or have severe anemia.
• You show symptoms of the fifth disease.
• Washing hands regularly and avoiding going to crowded places.
• Avoiding sharing food and drinks with other people.
• Going for weekly ultrasounds to understand the condition of the developing fetus. If the fetus condition deteriorates, the amniotic fluid can be tested to understand the extent of infection.

References

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Reviewer

Dr. Shashwat JaniMS

     

Dr. Shashwat Jani is a consultant obstetrician & gynecologist in Smt. N.H.L. Municipal Medical College, Ahmedabad. He has 14 years of experience with a special interest in high-risk pregnancy, infertility, and endoscopy.

Read full bio of Dr. Shashwat Jani