Epidemic of parvovirus B19 and disease severity in pregnant people, Denmark, January to March 2024.

We report an epidemic of parvovirus B19 infections in Denmark during the first quarter of 2024, with a peak incidence 3.5 times higher than during the most recent epidemic in 2017. In total, 20.1% (130/648) of laboratory-confirmed cases were pregnant. Severe adverse outcomes were observed among 12.3% (16/130) of pregnant people and included foetal anaemia, foetal hydrops and miscarriage. Parvovirus B19 infection is not systematically monitored, but a national laboratory-based surveillance system is currently being established in Denmark.

Prenatal detection of major congenital malformations in a cohort of 19 367 Danish fetuses with a complete follow-up six months after birth.

INTRODUCTION: To investigate the performance of the second-trimester ultrasound scan regarding ultrasound-detectable congenital malformations in a Danish region. The study sample was population-based, with 6 months of postnatal follow-up. Hospital records and autopsy reports were reviewed in each case to validate the prenatal ultrasound diagnosis. MATERIAL AND METHODS: This population-based cohort study included all fetuses (n = 19.367) alive at the second-trimester scan in four hospitals in a Danish region. The final diagnosis of the malformations was based on hospital records during the 6-month postnatal follow-up. In case of termination or stillbirth, the result from the autopsy report was used to validate the prenatal ultrasound diagnosis. RESULTS: The detection rate of congenital malformations in the prenatal screening program was 69%, where 18% was detected on the first-trimester scan and 51% on the second-trimester scan. Another 8% was detected in the third trimester. Specificity was 99.9%. The positive predictive value of the screening program was 94.5%, and the negative predictive value was 99.5%. The overall prevalence of malformations was 16.8 per 1000 fetuses, most frequently in the heart and the urinary tract. CONCLUSIONS: This study shows that the national screening program for congenital malformations can detect many severe malformations and is an effective screening test for malformations.

Parental information about the option to apply for pregnancy termination after the detection of a congenital abnormality and factors influencing parental decision-making: a cohort study.

BACKGROUND: The detection of an abnormality during prenatal screening implies that the parents are informed about possible treatment and management of the pregnancy, birth, and postnatal course. This information should enable the parents to make decisions regarding the pregnancy, especially in cases where termination of pregnancy may be an option. The objectives of this study were to investigate how often doctors informed parents about pregnancy termination when the fetus had an anomaly and which demographic factors were related to parental decision-making. METHODS: This was a retrospective cohort study with prospectively collected data of fetuses diagnosed with an abnormality during prenatal screening between 2014 and 2016 in Denmark. We categorized the abnormalities into five long-term prognosis groups and analyzed their association with the doctor provided information about termination. We tested the association between demographic variables and parental decisions using univariate and multivariate statistical analyses. RESULTS: Three hundred and twenty fetuses were diagnosed with an abnormality. In 67% of these cases, the parents were informed about termination. All parents whose fetus had a lethal prognosis were informed about termination. By comparison, the parents of 98% of fetuses with genetic disorders, 96% of fetuses with poor prognosis, 69% of fetuses with uncertain prognosis, and 12% of fetuses with good prognosis were informed about termination. Of these parents, 92% chose to terminate. A lethal long-term prognosis was the only factor related to parental decision to terminate a pregnancy. CONCLUSIONS: Doctors mainly informed parents about the option of pregnancy termination for conditions with a poor or lethal long-term prognosis or for genetic disorders. Only conditions with a lethal prognosis were significantly related to the parental decision to terminate the pregnancy.

Reasons for non-participation in malformation scans in Denmark: a cohort study.

BACKGROUND: The aim of the study was to estimate the proportion of women giving birth in two hospitals in the Region of Southern Denmark who did not attend the malformation scan and to elucidate the reasons for not participating. METHODS: In this register-based descriptive study, we used patient administration systems to identify women who had given birth at two Danish hospitals between March 2013 and January 2015. We then linked this information with the hospital database for fetal medicine (Astraia) to identify women who did not attend the malformation scan at week 18-20. We reviewed the medical records of these women to validate the data and to identify the reason for non-participation. RESULTS: Of 7690 births, 153 (2%) women did not attend the malformation scan. The main reason for non-participation was a passive deselection (81%). Most of these women were not present in Denmark at the time of the malformation scan (61%) and few women declined (8%). CONCLUSIONS: Less than 2% of a birth cohort in two major hospitals in Denmark did not attend the free offer of a malformation scan. Most of these women (81%) did not actively decide against the malformation scan. Very few (0.2%) declined the malformation scan. Non-attendance is not always due to an active decision made by the pregnant woman.

Improved prenatal detection of chromosomal anomalies.

INTRODUCTION: Prenatal screening for karyotype anomalies takes place in most European countries. In Denmark, the screening method was changed in 2005. The aim of this study was to study the trends in prevalence and prenatal detection rates of chromosome anomalies and Down syndrome (DS) over a 22-year period. MATERIAL AND METHODS: The study was based on data collected from the EUROCAT registry of congenital anomalies for Funen County. The registry includes information about live births, foetal deaths with a gestational age > 20 weeks and terminations of pregnancy after prenatal diagnosis of foetal anomaly (TOPFA). The study includes all foetuses/infants diagnosed with a chromosome anomaly born between 1986 and 2007 of a mother residing in Funen County. RESULTS: A total of 431 foetuses/infants had a chromosome anomaly corresponding to an overall prevalence of 35.6 chromosome anomalies per 10,000 births. This figure remained constant during the study period. Two hundred and three cases were live births (47% of total), 26 foetal deaths (6%) and 202 TOPFAs (47%). The prenatal detection rate for chromosome anomalies increased from 27% in the 1980s to 71% in the new millennium (p < 0.001). There were 235 cases with DS (55% of total cases), which yields an overall prevalence of 19 DS cases per 10,000 births. CONCLUSION: The prevalence of all chromosomal anomalies and DS did not change over time. The prenatal DS detection rate more than doubled from 1986-1989 to 2000-2007. The number of TOPFAs increased, which is consistent with a decrease in the number of live births with DS as well as in all chromosomal anomalies. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

[Hydronephrosis caused by a menstrual cup].

In this case report, a 20-year-old healthy woman contacted the emergency department because of lower abdominal pain radiating to the right flank. She was discharged with analgesics suspecting a kidney stone attack. One month later she contacted the emergency department again with the same symptoms. A CT urography was made showing hydronephrosis on the right side and a menstrual cup in the vagina seemingly compressing the right ostia in the bladder. After removal of the menstrual cup the symptoms disappeared, and the patient was discharged. A control ultrasound scan two weeks later showed full regression of the hydronephrosis.