Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Novel Insights from Clinical Practice Fetal Diagn Ther 2011;30:150–152 DOI: 10.1159/000323590 Early Signs of Cardiac Failure: A Clue for Parvovirus Infection Screening in the First Trimester? Teresa Carraca a Alexandra Matias a Otília Brandão b Nuno Montenegro b a Obstetrics and Gynecology Service and b Pathology Department, University Hospital of S. João, Faculty of Medicine of Porto, Porto, Portugal lence of parvovirus B19 maternal infection during pregnancy is about 1–2%. The vertical transmission occurs in 10–35%, being highest in the first and second trimesters. The risk of adverse fetal outcome is 10%. In contrast to the second or third trimester, in pregnancies affected by increased nuchal translucency (NT) in the late first trimester, the prevalence of maternal infection was not higher than in the general popu- lation. We report a case of first-trimester parvovirus B19 in- fection with increased NT and reversed a-wave in the ductus venosus (DV) at 11 weeks, with fetal demise 2 weeks later. Copyright © 2011 S. Karger AG, Basel Key Words Parvovirus  Reversed a-wave  Ductus venosus Abstract Parvovirus B19 is a small single-stranded DNA virus and a po- tent inhibitor of erythropoiesis due to its cytotoxicity to ery- throid progenitor cells. Although adult disease is generally mild, fetal parvovirus B19 infection can cause spontaneous abortion in early pregnancy and aplastic anemia, nonim- mune hydrops fetalis and in utero fetal demise. The preva- Received: October 25, 2010 Accepted after revision: December 14, 2010 Published online: February 16, 2011 Teresa Carraca Obstetrics and Gynecology Service University Hospital of S. João, Faculty of Medicine of Porto PT–4200-319 Porto (Portugal) Tel. +351 917 803 095, E-Mail teresacarraca  @  hotmail.com © 2011 S. Karger AG, Basel 1015–3837/11/0302–0150$38.00/0 Accessible online at: www.karger.com/fdt Established Facts • Although increased nuchal translucency (NT) is not commonly associated with fetal infection, parvovirus B19 infection is the only infection that has been reported in association with increased fetal NT. Novel Insights • First-trimester parvovirus B19 infection with reversed a-wave in the ductus venosus (DV) at 11 weeks. • Whenever an increased NT is found along with an abnormal DV flow in the first trimester of preg- nancy (11–14 weeks), the possibility of parvovirus infection must always be considered.