[go: up one dir, main page]
Scribd
Upload
655 views13 pages

Rubella in Pregnancy: Paryanto Departement of Obstetrics and Gynecology Faculty of Medicine J A M B I University

Rubella, also known as German measles, is a viral infection that can cause congenital rubella syndrome (CRS) if a woman is infected during pregnancy. CRS risk is highest if infection occurs during the first trimester and can cause deafness, eye defects, heart disease and intellectual disabilities in the fetus. Diagnosis is made through serology tests detecting antibodies or RNA from the rubella virus. Pregnant women should receive rubella vaccination after delivery to prevent infection during subsequent pregnancies. Therapeutic abortion may be considered if primary rubella infection is diagnosed during the first trimester due to high risk of CRS.

Uploaded by

andini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
655 views13 pages

Rubella in Pregnancy: Paryanto Departement of Obstetrics and Gynecology Faculty of Medicine J A M B I University

Rubella, also known as German measles, is a viral infection that can cause congenital rubella syndrome (CRS) if a woman is infected during pregnancy. CRS risk is highest if infection occurs during the first trimester and can cause deafness, eye defects, heart disease and intellectual disabilities in the fetus. Diagnosis is made through serology tests detecting antibodies or RNA from the rubella virus. Pregnant women should receive rubella vaccination after delivery to prevent infection during subsequent pregnancies. Therapeutic abortion may be considered if primary rubella infection is diagnosed during the first trimester due to high risk of CRS.

Uploaded by

andini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 13

RUBELLA IN

PREGNANCY

Paryanto
Departement of Obstetrics and
Gynecology Faculty of Medicine
J a m b i University
CONGENITAL RUBELLA
• Rubella is a teratogenic virus
• Congenital rubella syndrome (CRS) occur
during the US rubella epidemic of 1964
• The fetus is at risk of CRS only during
primary infection
• Possibilities fetal infection occurs during
first 4 weeks after conception 61%, 5-8 w:
26%; 9-12 w: 8%; after 12 w: <5%
CONGENITAL RUBELLA
SYNDROME
• The most common abnormalities
associated with 1st trim infection are:
hearing loss in 60%-755%; eye defect:
50-90%%; heart disease: 40-85%;
psychomotor retardation: 25-40%
• Other abnormalities are: IUGR,
hepatosplenomegaly
• Less frequent: thrombocytopeni,
meningoencephalities
EPIDEMIOLOGY
• Also called German measles, caused by
rubella virus
• Minor infections in the absence of
pregnancy
• During pregnancy directly responsible for
inestimable wastage, as well as for severe
congenital malformation
Continue
• Transmission from direct contact with the
nasopharyngeal secretion of an infected
person
• The most contagious periode is the few
days before the onset of a maculopapuler
rash
• The incubation period range 14 – 21 days
MATERNAL INFECTION
• Symptomatic in 50%-70%
• Mild, maculopapular rash for 3 days
• Low fever, headache, loss of appetide,
and sore throat
• Generalized lymphadenopathy (especially
postauricular, occipital)
• Transient arthritis
FETAL INFECTION
• At least 50% infected fetuses when primary
maternal infection occurs in the 1st trim, when
the greatest risk of congenital anomalies exiests
• Multiple organ system involvement
• Permanent congenital defect: cataracts,
microphthalmia, glaucoma, PDA, pulmonary
artery stenosis, atrioventricular septal defect,
deafness, microcephaly, encephalopathy,
mental retardition and motor impairement
Continue
• One third of infant asymptomatic at birth
may develop late manifestation, including
diabetes mellitus, thyroid disorders, and
precocious puberty
• Mortality
• Spontaneous abortion 4-9%, stillbirth 2-3%
• Overall mortality of infant with congenital
rubella syndrome is 5-35%
DIAGNOSIS
• Serology, because viral isolation
technically difficult, result of tissue culture
take up 6 weeks
• Antibody detection methods
hemagglutination inhibition, RIA latex
agglutination
• Fourfold or greater increase in titer or
seroconversion indicates acute infection
Continues
• If seropositive on the first titer, no risk to
the fetus
• Primary rubella confers lifelong immunity
however may be incomplete
• Antirubella IgM can be found in both
primary and reinfection rubella
• Reinfection rubella usually is subclinical,
rarely is associated with viremia
PRENATAL DIAGNOSIS
• Identification IgM in fetal blood by direct
puncture under US guidance at 22 weeks
of gestation or later
• The presence of rubella specific IgM
antibody in blood obtain by cordocentesis
indicates congenital rubella infection,
because IgM does not cross the placenta
MANAGEMENT
• Pregnant women should undergo rubella
serum evaluiation
• A clinical hystory of rubella unreliable
• If the patient is nonimmune, she should
receive rubella vaccine after delivery
• Contraception should be used for a
minimum 3 months after vaccination
• Theoretical risk of teratogenecity if vaccine
is used during pregnancy
Continue
• If pregnant women is exposed to rubella,
immediate serologic evaluation
• If primary rubella is diagnosed, the mother
should be informed about the implications
of the infection for the fetus
• If acute infection is diagnosed during the
first trim, the option of therapeutic abortion
shoud be considered

You might also like