A mum wants to raise awareness about the risks of slapped cheek syndrome during pregnancy after her daughter caught the illness at nursery and it was passed onto her unborn baby. Sadly, she lost her unborn child at 25 weeks due to the virus.
Farran Wilkins, 35, a receptionist, and her partner, Robert West, 34, from Gravesend, Kent, were expecting their first baby together when Farran’s daughter from a previous relationship, Maple, came home from nursery with fever, red cheeks, a runny nose and a rash.
Maple, three, was diagnosed with slapped cheek, also known as parvovirus B19, in April when Farran was 17 weeks pregnant. The illness mostly spreads through droplets like a cold and though it is not usually life-threatening, it can be to unborn babies.
Weeks later, a routine scan showed Farron’s unborn baby was unwell. She was diagnosed with a life-threatening condition resulting from the parvovirus, which had passed to her in the womb. Despite intervention, the baby, who the couple named Floss, didn’t recover, and was stillborn on June 14, which Farron describes as “the most heartbreaking thing we’ve ever been through.”
Neither Farran or Robert worried when Maple was ill with slapped cheek or when Farran developed a sore throat. But at her anomaly scan at 22 weeks doctors spotted fluid in Floss’ stomach, in her head and around her heart. Farran was referred to Professor Ranjit Akolekar, a specialist in foetal medicine, at Medway Hospital. He diagnosed Floss with a condition called hydrops – resulting from severe anaemia – in turn caused by parvovirus crossing the placenta.
When parvovirus infects a baby in the womb it causes severe anaemia – a lack of iron – so the baby’s blood becomes very diluted. Floss’ blood was a light yellow colour instead of red. The unborn baby’s body also becomes filled with fluid. And by the time she was diagnosed at 23 weeks, Floss was going into heart failure.
Professor Akolekar and his team gave Floss a blood transfusion through the umbilical cord, but a scan 10 days later showed the blood was watery again. Farron was also developing something called mirror syndrome, where her body was also filling with fluid, which was putting her own life at risk. Farron and Rob had to make the heartbreaking decision to terminate the pregnancy after being told Floss would not be able to recover.
“Even with the new blood she wasn’t able to fight the virus,” Farron says. “She had been struggling with watery blood for too long. “They said she would die of heart failure, and my life was at risk too. There was so much fluid in my legs that I couldn’t bend them.”
Farron is keen to tell her story to highlight what she describes as a lack of information about parvovirus, particularly as cases were reported to have increased across Europe last winter.
“Parvovirus is on the rise and nobody is aware of the risks,” she says. “I had no idea it could cross the placenta. “I had a sore throat and asked my GP about the risks but he said it would be fine, so he didn’t know the risks either. If I had known the risks and known there was a parvo outbreak at nursery I would never have sent Maple there.
The risk to pregnant women is currently classed as low to moderate, with babies up to 20 weeks being at highest risk. “We need to be better informed,” Farron adds. “I just want to save more babies.”
Slapped cheek syndrome and pregnancy: the facts
Dr Akolekar says Farran’s baby developed severe anaemia due to infection from Parvovirus B19 (slapped cheek syndrome).
“This is a relatively common infection in young nursery or school going children, especially at certain times of the year,” he explains. “Many mothers have already had an exposure to this infection prior to their pregnancy and this generally provides them immunity for life. If however, a mother has never had this infection prior to pregnancy and is then exposed to it during the pregnancy, there is a potential for this virus to cross from the mother to the baby across the placenta.”
If the infection occurs in the first half of the pregnancy, as in Farran’s pregnancy, Dr Akolekar says there is a higher chance of the baby being affected from the infection and becoming sick due to severe anaemia as opposed to infection later in pregnancy, which is unlikely to cause any major harm to the unborn baby.
Over the last 6-9 months Dr Akolekar says doctors have seen a significant increase in the incidence of pregnancies affected with severe parvovirus infection. He recommends all pregnant mothers should report to their GP or maternity units if they come into contact with anyone who has symptoms of Parvovirus B19.
Symptoms may include:
But Dr Akolekar suggests pregnant women seek advice whether they have symptoms or not themselves as often the signs can be so subtle that they can be missed.
“This is especially true for mothers who work in a nursery or school setting or if they have young children at home, as they are the ones who are most likely to acquire infection,” he adds.
The infection spreads via contact and therefore handwashing and hygiene is of utmost importance.
Dr Akolekar says it is also important for healthcare staff to ensure that mothers reporting with contact should have appropriate blood tests and an ultrasound scan to check if the baby has anaemia.
“This is vital as accurate and timely diagnosis of fetal anaemia can be successfully treated with excellent pregnancy outcomes,” he says.
“However delay in making a diagnosis has the potential for the anaemia to become severe which in turn causes the baby to become sick and if undetected, can also lead to a miscarriage or stillbirth.”
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