Rubella and pregnancy

Question 1

Rubella (german measles)

Answer 1

Togavirus
Rare due to MMR
Risk of congenital rubella syndrome if contracted during pregnancy

Incubation period 14-21 days. Individuals are infectious from 7 days before appearance of rash to 4 days after.

Question 2

Risk

Answer 2

First 8-10 weeks risk of damage to fetus is 90%

Damage is rare after 16 weeks

Question 3

Features of congenital rubella syndrome

Answer 3

Sensorineural deafness
Congenital cataracts
Congenital heart disease e.g. PDA
Growth retardation
Hepatosplenomegaly
Purpuric skin lesions
'Salt and pepper' chorioretinitis
Microphthalmia 
Cerebral palsy

Question 4

Diagnosis

Answer 4

Suspected cases should be discussed immediately with local Health Protection Unit
IgM antibodies raised in women recently exposed
Difficult to differentiate between rubella and Parvovirus b19 - check serology of this too

Question 5

Management

Answer 5

Rubella immunity not routinely checked during booking visit
Advised to stay away from people with rubella
Offer MMR vaccine in post-natal period