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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Rubella (German Measles) During Pregnancy
What is rubella?
Rubella, also called German measles, is a viral infection
that a baby can get from the mother before birth. If you
have this infection during pregnancy, it can harm the baby.
Rubella is also sometimes called the three-day measles.
Rubella is most likely to have serious effects on your baby
if you are infected during the first 3 months of pregnancy
(a 25% risk). However, the baby might also be affected if
you have rubella later in the pregnancy (a 1% risk). The
baby may develop a group of severe birth defects called
rubella syndrome.
How does it occur?
Rubella is caused by a virus. The virus spread is through
the air by coughing or sneezing. Rubella is contagious a
few days before symptoms of the illness appear and for 5 to
7 days after symptoms appear. Rubella tends to occur in
epidemics in the community.
What are the symptoms?
Adults may not have any symptoms. When symptoms occur they
may include:
- a rash that starts on the chest, spreads to other parts
of the body, and lasts 3 to 5 days (the most common
symptom).
- mild fever
- headache
- tiredness
- joint aches
- tender lymph nodes.
Examples of possible symptoms and problems for babies
infected with rubella are:
- deafness
- eye problems (cataracts)
- heart defects
- a small brain or swelling of the brain
- mental retardation.
Some of these problems may not appear until later in a
child's life.
How is it diagnosed?
When you are sick, your health care provider will ask about
your symptoms and examine you. You may have a blood test.
Your health care provider looks for eye, heart, and other
problems in the newborn. Samples of fluid from the baby's
nose and throat and of the baby's bowel movements and blood
may be tested. Other tests may also be done.
How is it treated?
If you are pregnant and have a rubella infection, medicine
called hyperimmune globulin may be given to you if you wish
to continue the pregnancy. This drug may reduce your
symptoms. However, the baby is still at risk of developing
rubella syndrome.
There is no specific treatment for newborns infected with
rubella.
How long will the effects last?
If you have a rash, it usually goes away in a few days and
you recover completely. However, the baby may have lifelong
disabilities.
What can be done to help prevent rubella?
Children over 1 year old and women of childbearing age
should be vaccinated against rubella. Blood tests to
determine whether you are immune to rubella should be done
before you try to get pregnant. You may be tested for
immunity on your first visit to your health care provider
when you are pregnant. If you are immune to rubella, there
is no danger of infection.
If you are pregnant and not immune to rubella, you cannot be
vaccinated until you are no longer pregnant. However, you
may be vaccinated while you are breast-feeding.
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