Fetal infection: a pragmatic approach to recognition and management

Viruses and parasites can be transmitted from a pregnant woman to her fetus via the placenta and can affect development of the fetus. Maternal infection is often asymptomatic or mild. The implications for the fetus are dependent on gestation, stage of organogenesis, the presence of maternal immunity and the virus type. Fetal infections are a potentially preventable cause of perinatal morbidity and mortality. Prenatal diagnosis is often initiated due to exposure of mother to an infectious contact. Management involves confirmation of maternal infection and careful consideration of the risks and benefits of fetal diagnosis, fetal surveillance, intrauterine treatment and possibly termination of pregnancy. Empathic and effective counselling of the parents is crucial and a multidisciplinary approach is important for optimal care. This review uses cases of two fetal infections to highlight a pragmatic approach to prenatal diagnosis and management. There is also an overview of three other fetal infections which can potentially cause serious morbidity and mortality.