Rubella is a virus infection with fever and rashes. Rubella
virus is an RNA virus from the togavirus family. There are symptoms such as
typical rash, mild fever, swelling of the lymph nodes, anorexia, headache and
joint pain, which start from the face and spread throughout the body. Not all
of these complaints always happen, for example, 5% without the rash.
Rubella is transmitted by viruses that spread through the air
with the sick person's cough and sneeze.
The infected person has an infectious disease 1 week before
the rash appears and within 4 days following the rash. The incubation period of
rubella varies between 14-21 days. People who have had the infection or those
who have had the vaccine will have life-long immunity, and will never repel
this disease. If the Rubella IgG assay in the blood is positive, the person is
immune to the disease. Very few adults who have not been immunized and
vaccinated can have the disease.
Anyone who thinks about pregnancy should be tested for
rubella IgG before pregnancy to find out whether they are immune. People who
are not immune must be vaccinated against rubella. It is recommended not to
conceive for 1 month after vaccination, but no problem has occurred in those
who conceived during this period. Therefore, it is not recommended to terminate
pregnancy in people who are vaccinated against rubella without knowing that
they are pregnant during the early pregnancy period.
Rubella vaccine is a live vaccine, it cannot be done during
pregnancy. Vaccination can be done during breastfeeding.
While the transmission of the virus to the fetus is 90% in
the infection in the first 12 weeks of pregnancy, it is 50% between 13-16
weeks, the transition to the fetus decreases after the 16th week, it decreases
to 35%, but it increases again in the last 2 months of pregnancy, even after
the 36th week. It goes up to the 90s.
What are
the effects on pregnancy?
Infection in pregnancy can cause various injuries (anomalies)
or even death or miscarriage in the baby.
Infection in the first 12 weeks of pregnancy affects the baby
at a high rate of at least 50%. Some of these result in miscarriage, while
others cause anomalies. Therefore, pregnancy should be terminated, especially
in infections that occur in the first 12 weeks. In those who do not want to
terminate the pregnancy, immune globulin can be given, immunglobulin can
relieve the infection in the mother, but it does not have a protective effect
on the baby.
Hearing problems are encountered in 50% of infections between
13-16 weeks.
The risk of infection to the fetus is lower in the 17th
gestational week and after.
The most common anomalies are eye problems, hearing loss,
heart and intelligence problems, meningitis, enlarged liver and spleen,
learning disability, anemia, nutritional difficulties, low birth weight.
Problems that occur in the baby are called "congenital rubella
syndrome". The classic triad of congenital rubella syndrome are cataracts,
deafness and heart anomalies.
Results:
- Sensorineural deafness (Additional frequent)
- Cataract, retinopathy, congenital cataract
- Microcephaly
- Ventriculomegaly
- Intracranial calcification
- Meningoencephalitis
- Cardiac malformations (Most common PDA, Most
pathognomonic finding: Supravalvular pulmonary stenosis)
- Mental retardation
- Pneumonia
- IUGR
- Hepatosplenomegaly
- Jaundice
- Hemolytic anemia
- Thrombocytopenia
Miscarriage is seen in 4-9% of pregnancies with rubella
infection, and stillbirth is observed in 2-3%.
Diagnosis
of infection in the mother:
In suspected pregnancies, the diagnosis is made by the
positive detection of Rubella IgM or the increase in the IgG titer, which is
looked after 15 days after the onset of complaints, or by the positive
detection of antibodies during pregnancy in the person who is known to be
immune at the beginning of pregnancy.
Diagnosis
of infection in the fetus:
Diagnosis of infection in the fetus can be made by showing
IgM antibodies in the fetus blood or virus in the amniotic fluid or chorionic
villi. Even if these tests show the fetus that the infection has passed, it
cannot give an idea about the degree of damage to the fetus. Also, the negative
results of these tests cannot always guarantee that there is no infection.
Termination
of pregnancy:
In the first 12 weeks of pregnancy, it is recommended to
terminate the pregnancy due to the high risk of the fetus being affected. It
can be decided according to the diagnostic methods that show the infection to
the fetus in the period of 13-16 weeks. After the 16th gestational week, the
risk of the fetus being affected is low, but if the family does not want to
take the risk, pregnancy can be terminated.
-COLD AND FLU IN PREGNANCY
-SYPHILIS INFECTION IN PREGNANCY
-CHICKENPOX AND SHINGLES INFECTION IN PREGNANCY
-TOXOPLASM INFECTION IN PREGNANCY
