Prenatal diagnosis and management of fetal infections

Authors

  • Meekai To MD MRCOG,

    Consultant in Fetal Medicine, Corresponding author
    1. Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London SE5 8RX, UK Email: meekai.to@kch.nhs.uk
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  • Michael Kidd MSc PhD FRCPath,

    Consultant Clinical Scientist and Honorary Senior Lecturer
    1. Department of Virology, University College London Hospitals NHS Foundation Trust, Level 5, Windeyer Building, Cleveland Street, London W1T 4JF, UK
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  • Darryl Maxwell MD FRCOG

    Consultant in Fetal Medicine and Director of Fetal Medicine Unit
    1. Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London SE5 8RX, UK Email: meekai.to@kch.nhs.uk

Abstract

  • • The risks of transplacental transmission and fetal damage are pathogen- and gestation-specific.
  • • Amniocentesis is the mainstay of diagnosis of fetal infection.
  • • Ultrasound surveillance is the primary tool for the detection of an affected fetus.
  • • Therapeutic options are restricted to intrauterine blood transfusion in parvovirus infection and maternal antibiotic therapy in toxoplasmosis infection.

Learning objectives:

  • • To gain an overview of prenatal diagnosis of the commonest congenital infections.
  • • To appreciate that optimal care involves a multidisciplinary approach.

Ethical issues:

  • • Detection of virus alone is not synonymous with fetal damage; a negative result does not completely exclude the possibility of fetal infection.
  • • Presence or absence of sonographic markers of fetal infection may not accurately predict long-term outcome.

Please cite this article as: To M, Kidd M, Maxwell D. Prenatal diagnosis and management of fetal infections. The Obstetrician & Gynaecologist 2009;11:108–116.

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