Dangers of Rubella in Pregnancy

Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. This is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. Rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles.

 

 

What Causes Rubella?

The cause of rubella is a virus that’s passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person’s respiratory secretions, such as mucus. It can also be transmitted from pregnant women to their unborn children via the bloodstream.

A person with rubella is contagious for one to two weeks before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it.

Rubella is rare in many developed countries because most children receive a vaccination against the infection at an early age. The disease, however, is still common in many under-developed and developing parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you’re pregnant.

Facts

  • Rubella is a contagious, generally mild viral infection that occurs most often in children and young adults.
  • It is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome.
  • There is no specific treatment for rubella but the disease is preventable by vaccination.

Symptoms of Rubella

When children get rubella, it’s usually a mild illness. Sometimes they have no symptoms at all, but they can still spread the infection to others.

Symptoms include:

  • A low-grade fever and mild aches and pains, sometimes red eyes. A rash of pink or light red spots that start on the face and spread down to the rest of the body. Neck glands may swell up and feel tender, especially behind the ears.

  • Rash of pink or light red spots that start on the face and spread down to the rest of the body. Neck glands may swell up and feel tender, especially behind the ears.

  • Enlarged, tender lymph nodes at the base of the skull, the back of the neck.

  • Aching joints, especially in young women.

The sickness lasts about 3 days and generally gets better on its own without any complications. In teens and adults rubella can be a more serious disease. Joint pain is common.

Rubella in pregnancy

Rubella is very rare in pregnancy. But if you get it when you’re pregnant, rubella could harm your baby.

It can cause:                

  • Loss of the baby (miscarriage).
  • Serious problems after the baby is born – such as problems with their sight, hearing, heart or brain.
  • If a pregnant woman gets rubella during the first 20 weeks of pregnancy, she usually passes the disease on to her unborn baby (fetus). The baby will have congenital rubella.
  • Should the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many life-long problems. The most common are eye problems, hearing problems and damage to the heart.
  • If the fetus gets rubella between 12 and 20 weeks of pregnancy, problems are usually milder.
  • There are rarely problems if the fetus gets rubella after 20 weeks of pregnancy.
  • Babies with congenital rubella are contagious for more than a year.

The risk is highest if you get rubella early in pregnancy.

What Can You Do To Prevent Rubella While You Are Pregnant?

If you have had the rubella infection or have the antibodies from the vaccine, you are likely protected. If you aren’t sure if you had a rubella vaccine, you should have a blood test before you get pregnant.

  • The test will tell you if you are protected against rubella.
  • If a blood test shows you are not protected against rubella, you should get the MMR vaccine right away. The vaccine should be given at least 4 weeks before you become pregnant. You cannot get this vaccine when you are pregnant.

If you are already pregnant and do not know if you are protected against rubella, ask your doctor to test you. And if you are not, avoid close contact with people who have rubella, and those who have had a rash for less than a week unless a doctor has told them that the rash is something other than rubella.

If you are not immune, you should be vaccinated as soon as possible after your baby is born, before leaving the hospital.

Diagnosis and Treatment of Rubella

The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you’ve had a recent or past infection or a rubella vaccine.

No treatment will shorten the course of rubella infection, and symptoms are often so mild that treatment usually isn’t necessary. However, doctors often recommend isolation from others — especially pregnant women — during the infectious period.

Prevention

The rubella vaccine is usually given as a combined measles, mumps, rubella inoculation, which contains the safest and most effective form of each vaccine. Doctors recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 4 and 6 years of age before entering school. It’s particularly important that girls receive the vaccine to prevent rubella during future pregnancies.

Usually babies are protected from rubella for six to eight months after birth because of the immunity passed on from their mothers. If a child requires protection from rubella before 12 months of age for example, for certain foreign travel, the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.

 

 

Sources

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