MASAC Document #150

MASAC Recommendations on the Use of Blood Products during Pregnancy and Testing for Parvovirus B19

The following recommendation was approved by the Medical and Scientific Advisory Council (MASAC) of the National Hemophilia Foundation on November 8, 2003, and adopted by the NHF Board of Directors on November 9, 2003.

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Parvovirus B19 infection during pregnancy may cause fetal anemia, hydrops fetalis, and fetal demise. Infection during the third trimester can induce severe congenital hypoplastic anemia in the infant. Parvovirus B19 may be transmitted by blood components such as cryoprecipitate and fresh frozen plasma. However, it is not expected to be transmitted by currently available clotting factor concentrates that have had NAT testing plus several viral attenuation methods applied.

Therefore, MASAC recommends that pregnant women with congenital bleeding disorders expected to be responsive to clotting factor concentrates who require treatment or prophylaxis for bleeding should be treated with those clotting factor concentrates rather than with cryoprecipitate or fresh frozen plasma. Additionally, MASAC recommends that, when clotting factor products are utilized for pregnant women with bleeding disorders, baseline pre-infusion testing for Parvovirus B19 should be done to include immune titers and PCR testing; these should be repeated post-infusion. Ideally this testing should be performed through a CDC testing program such as the UDC. Women who seroconvert and their physicians should be informed of this fact as expeditiously as possible.