Rubella during pregnancy

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Overview

Rubella or German measles is a mild form of usual measles virus. Rubella virus incubation lasts approximately 14-21 days (average 18 days), after which occurs physical manifestations.
This infection is unlike chickenpox or measles. Keep in mind that rubella epidemic occurs frequently especially during winter-spring and early summer.

Rubella is more dangerous to the fetus, during intra uterine life, if contacted during the first 16 weeks of pregnancy.

Rubella can cause miscarriage, premature birth and many congenital defects in the newborn:
- Deafness;
- Brain damage;
- Cardiac disorders;
- Cataract.

This form of the disease is called congenital rubella syndrome and is transmitted to the baby through the placenta. Rubella is rare because most people have been vaccinated against this disease during childhood or school.

Rubella is spread by coughing and sneezing and is highly contagious.


Contents

1. Overview
2. Investigation to verify immunity against rubella
3. Risks in pregnancy


Investigation to verify immunity against rubella

If a woman is planning to become pregnant she should make investigations to know if she is immunized against rubella or not. Even if a person has been vaccinated against rubella in childhood, the effects of the vaccine should be checked. If immunity to rubella virus is not developed, the vaccine will not be injected during pregnancy because of the viruses found in its composition that might cause rubella to the fetus. For the same reason, it is recommended to avoid pregnancy for at least one month after vaccination.

Symptoms of rubella are mild and include fever, headache, joint pain and sore throat. A red-pink rash on the skin appears shortly after the glands become inflamed.


Risks in pregnancy

Risks for normal development of the pregnancy during different periods of pregnancy are listed below.
- In the first trimester (weeks 0-13) – If a pregnant woman contacted rubella, there is a high risk (up to 90%) for the baby to be affected. If a pregnant woman is infected with rubella earlier, the risks are higher for children. After week 10 – the serious risks for children are reduced, but it can develop hearing problems that are not obvious until the child grows;
- In the second trimester weeks (14-26) – During the weeks 14-15 there are still risks for the child: he may have sight or hearing problems that will not be obvious until he grows;
- The third trimester (week 27 – birth) – After week 16 the risk for the child is low. If a pregnant woman knows it is not immune to rubella, she should stay away from infected people, especially in the first 16 weeks of pregnancy. If she does come into contact with a measles patient, the doctor should be contacted immediately. It can diagnose rubella and may recommend a test to detect if the fetus was affected.

If the child was affected with rubella, the mother will be encouraged to discuss with psychiatrist or counselor, doctor, nurse or midwife. There are many options available for parents who are expecting a baby affected by congenital rubella syndrome. People who follow chemotherapy or who have a weak immune system for other reasons, who are allergic to neomycin or polymyxin, should not be vaccinated against rubella.

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