Key result
Direct Enterovirus detection on vesicles (68.7%) was more sensitive than serology (1.9%) or blood detection (9.1%) for diagnosing hand, foot, and mouth disease in pregnant women.
Why the study?
Diagnostic strategies for hand, foot, and mouth disease (HFMD) in pregnancy and the risk of HFMD-related fetopathy required evaluation.
What are the optimal diagnostic strategies and fetal risks for hand, foot, and mouth disease in pregnancy?
Observational (n=128)
No
What are the optimal diagnostic strategies and fetal risks for hand, foot, and mouth disease in pregnancy?
Answers are grounded in this paper and cite their sources.
HFMD in pregnancy is primarily a clinical diagnosis where direct viral detection from vesicles is more sensitive than serology, and requires monitoring due to uncertain but possible fetal risks.
OBJECTIVE: Evaluation of hand, foot, and mouth disease (HFMD) diagnostic strategies in pregnancy and the risk of HFMD-related fetopathy. STUDY DESIGN: Pregnant women consecutively evaluated between 2010 and 2016 at the Tuscany Reference Center for Infectious Diseases in Pregnancy for HFMD were enrolled. A descriptive analysis of infected patients/newborns data and literature review were carried out. RESULT: Of the 128 women evaluated, 52 (41%) were symptomatic: 32 (61.5%) developed HFM vesicles, 12 (23%) palmoplantar vesicles, and 8 (15.5%) oral aphthae. Serological positivity and direct Enterovirus detection on blood and vesicle were obtained in 1.9% (1/52), 9.1% (1/11), and 68.7% (11/16), respectively. Three miscarriage and few cases of fetal/neonatal anomalies were reported. CONCLUSION: HFMD diagnosis is primarily a clinical diagnosis. Direct viral detection is more sensitive than serology. Considering our series and literature review, data on embryo-fetal-neonatal outcomes are not conclusive. Although the role of EV as causative agents of congenital defects remains uncertain, the described cases of unfavorable outcome impose prudence and monitoring of pregnant women with HFMD throughout the gestation.
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Giachè et al. (2019) conducted an observational in Hand, foot, and mouth disease (HFMD) in pregnancy (n=128). Hand, foot, and mouth disease (HFMD) was evaluated on Diagnostic sensitivity (serology vs direct Enterovirus detection) and fetal/neonatal outcomes. Direct Enterovirus detection on vesicles (68.7%) was more sensitive than serology (1.9%) or blood detection (9.1%) for diagnosing hand, foot, and mouth disease in pregnant women.
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