Rubella in Pregnancy Max Brinsmead MB BS Ph
Rubella in Pregnancy Max Brinsmead MB BS Ph. D January 2015
Rubella Infection Caused by the pleomorphic RNA virus of the genus Rubivirus l Infects only human subjects l In adults and children causes: l l Mild fever & malaise l Generalised fine erythematous rash – rarely purpuric l Cervical lymphadenopathy l Arthralgia
Rubella in a Pregnant Woman l Before 12 weeks pregnancy up to 90% risk of: Miscarriage l Cardiac anomalies l Nerve deafness l Cataracts or retinopathy l Mental retardation l Often multiple defects l l Fetus somewhat safer in the 2 nd trimester but… l l Sensineural deafness is the most common problem In the second half of pregnancy Hepatosplenomegaly l Failure to thrive, osteitis l Diabetes, hypothyroidism and GH deficiency l Progressive panencephalitis l = The Congenital Rubella Syndrome
Prevention of Congenital Rubella l l l Immunise all children at 12 -15 m (MMR) Test all women who are pregnant (or plan to conceive) for immunity Avoid infection if pregnant l l Spread by nasopharyngeal droplets +/- 7 days from the time of rash Retest any pregnant woman who is exposed to the virus Terminate pregnancy for proven infection Immunise women postpartum if low titre or non immune l Immunisation of a pregnant woman with the live virus is not recommended but is also not associated with teratogenesis
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