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O&G CasesAntenatal care — fetal medicine

O&G Cases · Antenatal care — fetal medicine

Parvovirus hydrops — fetal anaemia management station

Fetal-medicine management station: parvovirus B19 aplastic anaemia with early hydrops. Tests the pathogenesis explanation, the MCA-PSV surveillance and 1.5 MoM threshold, intrauterine transfusion technique and survival, and honest counselling. Includes assessor key and marking domains.

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Target exams

FRANZCOGMRCOGABOG
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Target exams

FRANZCOGMRCOGABOG
Prompt
A 26-year-old childcare worker, G1P0 at 21 weeks, presents with a flu-like illness followed by a rash. Maternal parvovirus B19 IgM is positive and PCR confirms recent infection. The 22-week ultrasound shows fetal ascites, scalp oedema and an MCA peak systolic velocity of 1.6 multiples of the median. You are the registrar working with the fetal medicine consultant on the phone.

Station brief

Format. Fetal-medicine management station, approximately 12 minutes. You are the registrar; the fetal medicine consultant is on the phone and will be available in theatre. The assessor runs the clock and feeds scan findings. [1]

Candidate instruction. Explain the diagnosis and mechanism, lay out the surveillance and the intrauterine transfusion plan, set up the procedure, and counsel the woman. Verbalise thresholds, technique and realistic outcomes. [1][2]

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References4ShowHide
  1. [1]Norton ME, Chauhan SP, Dashe JS Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #7: nonimmune hydrops fetalis Am J Obstet Gynecol, 2015.PMID 25557883
  2. [2]Mari G, Norton ME, Stone J, et al. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia—diagnosis and management Am J Obstet Gynecol, 2015.PMID 25824811
  3. [3]Enders M, Weidner A, Zoellner I, Searle K, Enders G Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases Prenat Diagn, 2004.PMID 15300741
  4. [4]Moise KJ Jr Management of rhesus alloimmunization in pregnancy Obstet Gynecol, 2008.PMID 18591322
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