German Measles in Pregnancy

Dr. Margarita Isabel Amoroso-Artes

Department of OB/GYN

Davao Medical Center

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Minor importance in absence of pregnancy During pregnancy:

Directly responsible for abortion & severe congenital malformations

Congenital Rubella Syndrome

TERATOGENIC

12 weeks AOG- 80%

13-14 weeks- 54%

End of 2nd trimester- 25%

Eye defects- cataract & glaucoma Heart disease- PDA & Peripheral pulmonary

artery stenosis Sensorineural deafness- most common single

defect CNS- microcehaly, developmental delay, MR,

meningoencephalitis Purpura Hepatosplenomegaly & jaundice Radiolucent bone disease

Neonates with the disease

Continue to she the virus for months

Threat to other infants as well as to adults

Diagnosis Mild febrile illness

Generalized maculopapular rash

Arthralgias/arthritis Lymphadenopathy

Suboccipital Postauricular cervical

conjunctivitis

Incubation period- 12 t0 23 days

20-50% asymptomatic

Viremia precedes clinical signs by a week

Adults are infectious during viremia through 5-7 days of rash

Clinical

ELISA- specific IgM antibody 4-5 days after onset Persist 8 weks after rash appearance

ELISA- IgG antibody Peaks 1-2 weeks after rash onset If specimen obtained 10 days after rash:

failure to differentiate very recent disease & preexisting immunity

Prevention

25% in the US susceptible (large epidemics have disappeared)

Congenital Rubella still common in developing countries

Goal: ERADICATION

Immunization of the adult population

MMR- offered to women of childbearing age

Vaccination Part of general routine medical checkup In family planning settings Provided routinely to unimmunized women after

hospitalization, childbith or abortion

End

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