Slapped cheek syndrome in pregnancy

If you catch slapped cheek syndrome for the first time in pregnancy there is a small risk of complications, although most women who catch the disease go on to have healthy babies. Here we explain what the disease is, its treatment and how it could affect your unborn baby.

What is slapped cheek syndrome?

Slapped cheek syndrome is caused by the parvo B19 virus; it's sometimes known as the fifth disease.

Over 50% of adults have had the infection at some point in their lives and are therefore immune to it.  This viral infection affects mainly children between the ages of three and 15 years, although babies and adults can be affected too. The virus is spread in tiny droplets in the air and can also pass from a mother to her unborn baby during pregnancy via the placenta.

What are the symptoms of slapped cheek syndrome in pregnancy?

Slapped cheek syndrome in adults doesn’t always cause symptoms, so you may not realise you’ve been infected. However, you may have a:

• Headache
• A runny nose
• A sore throat
• A slight fever and feel generally unwell, as if you have a cold.
• Another common symptom of the disease in adults is joint pain and stiffness affecting the knees, ankles, wrists and hands.

It’s unusual for adults to get the characteristic ‘slapped cheek’ rash seen in children, but you may notice a faint lace-like red rash on your body, arms and legs. This rash begins two to three weeks after the initial symptoms and then gradually fades over another three weeks, but it may return if you get very hot, exercise or are in sunlight.

Should I seek medical advice?

If you’re pregnant and think you’ve been exposed to the slapped cheek virus, contact your GP or midwife, even if you don’t have any symptoms. You should also speak to them if you have any type of rash during pregnancy.

Slapped cheek syndrome in adults is difficult to diagnose from the symptoms alone, so a blood test will be recommended to see if you have the virus. You will usually be checked for the rubella virus at the same time, as this can cause similar symptoms.

How can I treat the symptoms?

There’s no specific treatment for slapped cheek syndrome. Speak to your midwife about whether you should take paracetamol if you feel really unwell, but otherwise rest and drink plenty of fluids.

Regular hand washing may stop you passing the infection to your friends, family and work colleagues. However, as you’re no longer infectious by the time the rash and joint pain appear, you don’t need to stay off work, unless you feel unwell.

Will slapped cheek affect my unborn baby?

If you test positive for slapped cheek syndrome in pregnancy, you will be referred for regular ultrasound monitoring during pregnancy to check on the health of your baby. Most pregnant women won’t be seriously affected by the infection, but very occasionally the slapped cheek virus can cause a miscarriage or harm an unborn baby. This is more likely to happen if you become infected before 20 weeks of pregnancy.

If you have the infection between nine and 20 weeks of pregnancy, there is a small chance that your developing baby will develop anaemia or fetal hydrops – a serious and life-threatening condition causing a build up of fluid in your baby’s body, which can lead to heart and liver problems. Your baby will need specialist obstetric and neonatal care and may require a blood transfusion while still in the womb.

It’s important to remember that in most cases the baby will not be affected.