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Rubella in Pregnancy. Max Brinsmead PhD FRANZCOG October 2008. Rubella Infection. Caused by the pleomorphic RNA virus of the genus Rubivirus Infects only human subjects In adults and children causes: Mild fever & malaise Generalised fine erythematous rash – rarely purpuric
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Rubella in Pregnancy Max Brinsmead PhD FRANZCOG October 2008
Rubella Infection • Caused by the pleomorphic RNA virus of the genus Rubivirus • Infects only human subjects • In adults and children causes: • Mild fever & malaise • Generalised fine erythematous rash – rarely purpuric • Cervical lymphadenopathy • Arthralgia
Rubella in a Pregnant Woman • Before 12 weeks pregnancy • Miscarriage • Cardiac anomalies • Nerve deafness • Cataracts or retinopathy • Mental retardation • Fetus somewhat safer in the 2nd trimester but… • In the second half of pregnancy • Hepatosplenomegaly • Failure to thrive, osteitis • Diabetes, hypothyroidism and GH deficiency • Progressive panencephalitis = The Congenital Rubella Syndrome
Prevention of Congenital Rubella • Immunise all children at 12 -15m (MMR) • Test all women who are pregnant (or plan to conceive) for immunity • Avoid infection if pregnant • 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 • Immunisation of a pregnant woman with the live virus is not recommended but is also not associated with teratogenesis