{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:34:33Z","timestamp":1762842873523,"version":"build-2065373602"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hydrops fetalis (HF) is a severe fetal condition, and congenital Parvovirus B19 (B19V) infection is a leading cause of the non-immune form (NIHF). The recent European B19V outbreak has had a substantial impact on obstetric and neonatal outcomes, leading to an increase in fetal anemia, NIHF, spontaneous abortions, and intrauterine demise. While prenatal diagnosis and intrauterine interventions are well established, postnatal management of B19V-related NIHF remains challenging and outcomes are often poor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a preterm newborn with B19V-associated NIHF following intrauterine transfusions for severe fetal anemia. At birth, the neonate had generalized edema, ascites, and respiratory compromise. Despite aggressive medical management, the patient developed persistent, refractory edema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Given the failure of conservative therapy, peritoneal dialysis (PD) was initiated as a rescue strategy. PD allowed gradual interstitial fluid removal, microcirculatory recovery, and functional \u201crenal rest\u201d after prolonged pharmacologic stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome<\/jats:title>\n                    <jats:p>The neonate progressively improved, with resolution of edema, normalization of renal function, and successful respiratory weaning. At 12 months of corrected age (CA), neurodevelopmental milestones were appropriate, although ongoing long-term surveillance is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case contributes to the limited evidence on postnatal management of B19V-related NIHF. PD may be considered in neonates with persistent, refractory edema despite maximal conventional therapy, with careful individualization of treatment. Further research, including multicenter registries and controlled studies, is needed to define its role within standardized neonatal care protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1611058","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:32:00Z","timestamp":1762842720000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal management of parvovirus B19-induced hydrops fetalis: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Marco","family":"Colombo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Lorioli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Pagani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Patan\u00e8","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Cheli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Mangili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.clp.2023.02.004","article-title":"Pathogenesis of non-immune hydrops fetalis: insights from recent genomic and clinical advances","volume":"50","author":"Younge","year":"2023","journal-title":"Clin Perinatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41436-020-00967-0","article-title":"A systematic review of monogenic etiologies of nonimmune hydrops fetalis","volume":"23","author":"Quinn","year":"2021","journal-title":"Genet Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"465","DOI":"10.3390\/diagnostics15040465","article-title":"Fetal hydrops: genetic dissection of an unspecific sonographic finding-a comprehensive review","volume":"15","author":"Mastromoro","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1002\/pd.6181","article-title":"Parvovirus B19-associated hydrops fetalis: clinical presentation, management, and outcome in a national cohort","volume":"42","author":"Kielaite","year":"2022","journal-title":"Prenat Diagn"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.3390\/v16091352","article-title":"Reassessing the risk of severe parvovirus B19 infection in the immunocompetent population: a call for vigilance in the wake of resurgence","volume":"16","author":"Ceccarelli","year":"2024","journal-title":"Viruses"},{"key":"B6","doi-asserted-by":"publisher","first-page":"9630","DOI":"10.1038\/s41598-024-59582-7","article-title":"Changing epidemiology of parvovirus B19 in The Netherlands since 1990, including its re-emergence after the COVID-19 pandemic","volume":"14","author":"Russcher","year":"2024","journal-title":"Sci Rep"},{"key":"B7","volume-title":"Communicable Disease Threats Report, 21\u201327 April 2024, Week 17","year":"2024"},{"key":"B8","volume-title":"Communicable Disease Threats Report, 2\u20138 June 2024, Week 23","year":"2024"},{"key":"B9","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1053\/plac.1998.0373","article-title":"Globoside expression within the human placenta: implications for parvovirus B19 transplacental transmission","volume":"20","author":"Jordan","year":"1999","journal-title":"Placenta"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e2104","DOI":"10.1002\/rmv.2104","article-title":"Parvovirus B19 infection and myocarditis: a review of the literature with a case series of patients with fulminant myocarditis","volume":"30","author":"Attwood","year":"2020","journal-title":"Rev Med Virol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e475","DOI":"10.1016\/S1473-3099(24)00373-6","article-title":"Extreme upsurge of parvovirus B19 resulting in severe fetal morbidity and mortality","volume":"24","author":"Russcher","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1002\/pd.2714","article-title":"Parvovirus B19 infection in pregnancy: new insights and management","volume":"31","author":"de Jong","year":"2011","journal-title":"Prenat Diagn"},{"key":"B13","doi-asserted-by":"publisher","first-page":"100007","DOI":"10.1016\/j.amolm.2023.100007","article-title":"Parvovirus B19: insights and implications for pathogenesis, prevention and therapy","volume":"1","author":"Zakrzewska","year":"2023","journal-title":"Aspects Mol Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1620\/tjem.190.65","article-title":"Pathogenesis of nonimmune hydrops fetalis caused by intrauterine B19 infection","volume":"190","author":"Yaegashi","year":"2000","journal-title":"Tohoku J Exp Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1002\/uog.27543","article-title":"Parvovirus B19 infection in pregnancy: a prospective cohort study on seroprevalence, seroconversion, fetal complications and outcome","volume":"63","author":"Kagan","year":"2024","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1002\/ajmg.a.34438","article-title":"Non-immune hydrops fetalis: a short review of etiology and pathophysiology","author":"Bellini","year":"2012","journal-title":"Am J Med Genet A"},{"key":"B17","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1055\/s-2007-999396","article-title":"Nonimmune hydrops fetalis managed with peritoneal dialysis","volume":"2","author":"Caldwell","year":"1985","journal-title":"Am J Perinatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.12659\/MSM.898271","article-title":"The use of acute peritoneal dialysis in critically ill newborns","volume":"22","author":"Ustyol","year":"2016","journal-title":"Med Sci Monit"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1093\/cid\/ciae248","article-title":"Parvovirus B19 resurgence in France after the COVID-19 pandemic: a multicenter observational study","volume":"79","author":"d\u2019Humi\u00e8res","year":"2024","journal-title":"Clin Infect Dis"},{"key":"B20","doi-asserted-by":"publisher","first-page":"4868","DOI":"10.1128\/JVI.00029-10","article-title":"Parvovirus B19 infection in primary human endothelial cells leads to caspase activation and apoptotic cell death","volume":"84","author":"Ryu","year":"2010","journal-title":"J Virol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"8102","DOI":"10.1128\/JVI.00649-14","article-title":"Antibody-mediated enhancement of parvovirus B19 uptake into endothelial cells mediated by a receptor for complement factor C1q","volume":"88","author":"von Kietzell","year":"2014","journal-title":"J Virol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"606","DOI":"10.3390\/biom11040606","article-title":"The effect of a unique region of parvovirus B19 capsid protein VP1 on endothelial cells","volume":"11","author":"Rink\u016bnait\u0117","year":"2021","journal-title":"Biomolecules"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1007\/s00467-020-04820-1","article-title":"Clinical utility of biomarkers for the diagnosis and management of acute kidney injury in children","volume":"36","author":"Rutledge","year":"2021","journal-title":"Pediatr Nephrol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/s00467-023-06145-1","article-title":"Peritoneal dialysis in critically ill neonates and infants: a multicenter Italian study","volume":"39","author":"Cortina","year":"2024","journal-title":"Pediatr Nephrol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1097\/MOP.0000000000000464","article-title":"Update on acute kidney injury in the neonate","volume":"29","author":"Jetton","year":"2017","journal-title":"Curr Opin Pediatr"},{"key":"B26","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1007\/s13312-020-1799-5","article-title":"Acute peritoneal dialysis in premature infants","volume":"57","author":"Okan","year":"2020","journal-title":"Indian Pediatr"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1016\/S0140-6736(68)91974-0","article-title":"Severe hydrops foetalis treated with peritoneal dialysis and positive-pressure ventilation","volume":"1","author":"Nathan","year":"1968","journal-title":"Lancet"},{"key":"B28","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s00467-009-1347-y","article-title":"Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter","volume":"25","author":"Yu","year":"2010","journal-title":"Pediatr Nephrol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.jpedsurg.2022.08.021","article-title":"Acute peritoneal dialysis in the newborn: a safe and feasible method","volume":"58","author":"Ger\u00e7el","year":"2023","journal-title":"J Pediatr Surg"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.3390\/nu16091719","article-title":"Human milk and breastfeeding in non-immune hydrops fetalis: a narrative review on nutritional and immunological aspects","volume":"16","author":"De Rose","year":"2024","journal-title":"Nutrients"},{"key":"B31","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1055\/s-0034-1395538","article-title":"Non-immune hydrops fetalis due to parvovirus B19 infection in 2 extremely preterm infants: perinatal management and long-term neurodevelopmental outcome","volume":"219","author":"Welcker","year":"2015","journal-title":"Z Geburtshilfe Neonatol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"166198","DOI":"10.1016\/j.bbadis.2021.166198","article-title":"Pregnancy and viral infections: mechanisms of fetal damage, diagnosis and prevention of neonatal adverse outcomes from cytomegalovirus to SARS-CoV-2 and Zika virus","volume":"1867","author":"Auriti","year":"2021","journal-title":"Biochim Biophys Acta Mol Basis Dis"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1611058\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:32:01Z","timestamp":1762842721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1611058\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":32,"alternative-id":["10.3389\/fped.2025.1611058"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1611058","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]},"article-number":"1611058"}}