The term fifth disease is a remnant of a historical list of common childhood illnesses causing fever and rash. It refers to a contagious viral illness caused by the human parvovirus B19. The fifth disease spreads through sneezing, coughing and other bodily fluids. Most cases of the fifth disease are generally mild but may cause harm to your baby if you get infected when pregnant. So, what should you do if you have fifth disease and pregnancy? Let’s find it out in this discussion.

How Will Fifth Disease Affect Pregnancy?

Assuming that you are not immune and contract the disease when pregnant, it’s most probable that your baby will not be harmed. However, there is a 33 percent chance that the virus will get to your baby through the placenta. The good news is that even in such cases, majority of the babies don’t get the disease.

Still, in a few cases, infection with the fifth disease during pregnancy leads to stillbirths, miscarriage, fetal anemia or inflammation of the new baby's heart. In case the baby’s heart inflammation or anemia is severe, it can lead to a condition in which there is excess fluid in tissues (hydrops). This condition can be fatal.

Around 10 percent of pregnant women who get the infection before 20 weeks of pregnancy lose their babies, but the loss may come after several weeks or a few months following the infection with the virus. Less than one tenth of babies whose mothers are infected after mid-pregnancy suffer from the fifth disease complications.

What Are the Symptoms of Getting Fifth Disease During Pregnancy?

The most common symptoms of parvovirus infection include:

• Fatigue
• Fever
• Joint pain
• A rash on the arms, cheeks, thighs or all over the body, although some adults don’t get a rash

In most cases, the redness caused by the rash fades within 10 days with medication. Parvovirus incubation period (time from infection to appearance of symptoms) ranges between 4 and 14 days.

It is worth noting that an individual with fifth disease and pregnancy or even without pregnancy is highly contagious during the incubation period (before the appearance of the rashes). After the rashes appear, the infected person ceases to spread the disease to people around.

The fifth disease presents with symptoms similar to those of flu, making it a challenge to know if one has flu or parvovirus infection. Therefore, by the time the rash appears and the cause is diagnosed to be the fifth disease, probably all those around will already be infected.

What to Do If You Suspect You Have Been Infected

Contact your doctor or healthcare provider immediately. Do not wait for the rash to appear.

The healthcare professional may need to take a blood sample to test it for parvovirus antibodies and to determine if you are immune, have been infected, or are at risk of infection. Your doctor may want the test repeated if he/she suspects the infection remains after treatment.

In case your blood test results show that you were recently infected, the doctor can order for ultrasounds to investigate the state of fluids in the baby's tissue (hydrops), besides other signs of complications, like excess amniotic fluid and excessively large or swollen placenta. A Doppler sonography, a noninvasive ultrasound test, may also be done to show the status of your baby's blood flow as well as check for symptoms of fetal anemia.

In case your baby looks fine and does not develop problems within months, relax. It is most likely that no fifth disease and pregnancy problems will develop.

In the event that testing shows signs of fetal hydrops or anemia, you may need to undergo an invasive test known as percutaneous umbilical blood sampling. For this procedure, a high-risk pregnancy specialist (a perinatologist) inserts a special needle into the uterus using ultrasound guidance, to draw blood from the baby's cord for anemia testing. In case severe anemia is diagnosed, the doctor may recommend fetal transfusion, whereby your baby gets a blood transfusion through the umbilical cord vein.

This procedure has its own risk; however, it improves your baby’s survival rate, especially in severe cases. But, in case of mild anemia and improving hydrops, you may only need continuing monitoring by ultrasound and Doppler sonography. Most of the reported studies have found that those babies who survive after getting infected during pregnancy do not have higher incidences of defects at birth or developmental risks than those born to uninfected mothers.

How to Prevent Fifth Disease During Pregnancy

No vaccine has been developed for fifth disease; therefore, prevention is the best action. Following are some of the ways through which you can reduce your risk of infection:

• Always wash your hands with warm running water and soap after any contact with children.
• Discard tissues used on or by children.
• Avoid sharing cups, drinking glasses, forks, spoons or other utensils used by anyone with fifth disease or those who have come into contact with a person with the disease.
• Avoid large crowds or crowded places when you are pregnant.
• Eat a healthy diet, walk often, and take vitamin supplements to stimulate your immune system.

Worry about fifth disease and pregnancy? Prior to pregnancy planning, request for parvovirus B19 antibodies test when undergoing standard screening to rule out infection and to have the disease treated if infected. In addition, make it a point to tell your doctor about any unusual sensations or painful feelings. He/she will be better able to help you so as to prevent any serious problems and to offer timely treatment.