Patient: [Patient Name]
MRN: [Medical Record Number]
Date: [Date of Encounter]
Reason for Visit:
Evaluation for possible Parvovirus B19 infection during pregnancy
Confirmation of Parvovirus B19 infection by serologic testing
Follow-up for diagnosed Parvovirus B19 infection in pregnancy (fetal monitoring)
History of Present Illness:
Date of symptom onset (if any): fever, rash (slapped cheek rash),
joint pain, fatigue.
Gestational age at the time of suspected infection.
Previous history of Parvovirus B19 infection (may be asymptomatic
in some cases).
Past Medical History:
Underlying medical conditions (e.g., chronic illnesses).
Current prenatal care status.
Physical Examination:
General examination: Assess vital signs for fever.
Fetal monitoring (if indicated): Doppler ultrasound to assess
fetal heart rate and signs of fetal anemia (hydrops fetalis).
Diagnostic Tests:
Serologic testing:
IgM antibody: Positive IgM indicates recent infection.
IgG antibody: Positive IgG indicates past infection and immunity.
Fetal ultrasound (if indicated): May be used to assess for
fetal anemia (signs of hydrops fetalis) if Parvovirus B19 infection is
confirmed during pregnancy.
Assessment:
Suspected Parvovirus B19 infection in pregnancy: Based on
clinical presentation (symptoms) and gestational age at the time of
suspected infection.
Confirmed Parvovirus B19 infection: Positive IgM antibody test
during pregnancy.
Fetal risk: Depends on the timing of infection during pregnancy.
First trimester infection carries a higher risk of fetal anemia compared
to later trimesters.
Differential Diagnoses:
Consider other conditions that may cause similar symptoms:
Other viral infections (e.g., rubella, fifth disease)
Bacterial infections
Plan:
Management plan: Depends on the stage of pregnancy and
confirmation of infection.
Supportive care: Monitor for symptoms and manage them
symptomatically (fever reducers, pain medication).
Fetal monitoring: Close monitoring with serial ultrasounds
and Doppler flow studies to assess for signs of fetal anemia.
Amniocentesis (if indicated): In some cases, amniocentesis
may be performed to assess fetal blood cell count and determine
the need for intrauterine blood transfusion.
Referral to a high-risk pregnancy specialist: May be
recommended for complex cases or ongoing concerns about fetal
well-being.
Prognosis:
Most pregnant women with Parvovirus B19 infection deliver healthy
babies.
Early diagnosis and close fetal monitoring are crucial to
identify and manage potential complications like fetal anemia.
Patient Education:
Educate the patient about Parvovirus B19 infection, symptoms,
and risks during pregnancy.
Reassurance and support are important, as most cases have good
outcomes.