Both rubella and PVB19 present with a rash, and differentiation between the two continues to present diagnostic problems; hence, investigations for acute rubella or parvovirus B19 infection should always be undertaken, irrespective of vaccination history (rubella) or prior antibody testing (rubella or parvovirus B19).
The main effect of parvovirus infection is fetal anaemia which commonly presents by non-immune hydrops, diagnosed on an ultrasound scan and treated by intrauterine transfusion.
Parvovirus infection is not an indication for termination.
The risk to the fetus of primary rubella in the first 16 weeks of gestation is substantial.
The management of primary rubella, symptomatic and asymptomatic rubella reinfection depends on the point in gestation in which rubella occurred, and the individual circumstances of the women.