Viral Infection in Hydrops Fetalis, Spontaneous Abortion and Unexplained Fetal Death in utero

Marwan Al-Buhtori (1) , Lynette Moore (2) , Emyr W Benbow (3) , Robert James Cooper (4)

1 Virology, School of Translational Medicine
2 SA Pathology
3 Manchester Medical School
4 Virology, School of Translational Medicine

This study is to investigate the occurrence of viral infection in fetal death by examining tissues for the presence of DNA of several viral agents. Tissue specimens including heart, kidney, liver, lung and placenta of 73 cases of fetal death were examined with 27 cases of elective termination of pregnancy as a control group. DNA extracted from these samples was tested for the presence of HSV, CMV, EBV, VZV, HHV-6, HHV-7 and PVB19. Viral DNA was found in one or more tissue samples from 25/73 cases (34%): CMV in 20, HSV in 5, parvovirus B19 in 5, HHV7 in 3 and HHV6 in 2. The presence of HHV6 in fetal tissue has rarely been reported. Moreover, no study so far has reported the detection of HHV7 in fetal tissues with normal or adverse outcomes. Viral DNA was not found in any of the termination of pregnancy samples. Among the positive cases, 8 had dual infection. One further case was positive for three viruses: HSV, CMV and HHV7. HHV6 was the sole infectious agent in two cases, HHV7 in one case, PVB19 in three and CMV in 10 cases. The finding of multiple viral DNA in 12% of the cases suggests the involvement of complex risk factors in cases of fetal loss. Although the cause of fetal death often includes other factors (e.g. chromosomal abnormalities) these data suggest the incidence of viral infective aetiology may be higher than previously considered.

Mots clés: Medicine

Marwan Al-Buhtori, Lynette Moore, Emyr W Benbow, Robert James Cooper. Viral Infection in Hydrops Fetalis, Spontaneous Abortion and Unexplained Fetal Death in utero. Journal of Medical Virology, 2011, 83 (4), pp.679. ⟨10.1002/jmv.22007⟩. ⟨hal-00614690⟩