Slapped cheek infection in pregnancy

Slapped Face or Slapped Cheek is a viral infection that is common in children. It is due to the Parvo B19 virus and affects young children. Found at times in epidemics in kindergarten, primary school or playgroups, it manifests as a cold with a rash on the face. Just like the child has been slapped!
The importance is that if the pregnant woman contacts it and develops the illness, then it could spread to the baby in the womb to affect it. It can suppress the bone marrow of the developing baby and cause it to fail to develop red blood cells. Thus the baby can become anaemic and if severe, may develop heart failure and may succumb from this.

The most important time that it can affect the developing baby is when it is still early in the pregnancy. It will be too small to counter the effect of the virus. Babies up to 30 weeks pregnancy can be at risk, although the risk lessens considerably past the 20 week mark. Immunity to the virus can only be achieved by contacting the infection. There is no vaccine.

If exposed, it is important not to panic. Firstly exposure does not mean you will be infected even if you are not immune. However, it would be wise to check for infection even in the absence of symptoms. This is because sometimes the symptoms are very mild and may not be noticed.

I check all my patients at the beginning of pregnancy to see if they have immunity. If you have not already been checked and is exposed, then you should get a blood test the next day. Obviously if you already have immunity confirmed, then exposure is of no concern.

In those without immunity, a repeat blood test 2-3 weeks later would help to confirm if you have been infected. If you have not then, there is no need for concern.

For those who become infected in pregnancy, then they will need to have regular ultrasound scans to check the baby for the development of changes that may indicate anaemia. These scans are performed 2 weekly and how many you need will depend on the stage of pregnancy that you were infected.

Even if anaemia is detected many babies can overcome this problem as they progress in the pregnancy. For those who cannot then it may be possible to perform a blood transfusion in them whilst they are still in the womb. This is not a simple procedure and does carry risks as well to the baby. Most however, will not come close to needing it.

These notes reflect my personal opinion and are intended for general advice only. It should not be used for any one individual case. You should consult your own doctor to determine the appropriate management of your own individual situation.