The article was consulted professionally by Dr. Nguyen Thai Ngoc Chau – Department of Pediatrics – Newborn, Share99 Phu Quoc International Health Hub. He has 9 years of experience in the field of Pediatrics – Newborn, former deputy head of pediatrics department of Phuong Chau International Health Hub (Can Tho). His strengths are examination and treatment of child nutrition issues, pediatric emergency resuscitation, pediatric pathology treatment.
If a pregnant woman is infected with rubella then the virus can pass through the placenta and transmit it to the fetus, causing congenital rubella syndrome. In case the mother becomes ill at a smaller gestational age, the higher the incidence of congenital rubella.
1. Rubella overview
Rubella, also known as German measles, is an infectious disease caused by the rubella RNA virus, the family Togaviridae. According to epidemiology, the disease occurs all over the world, peaking in winter or spring, but can also appear scattered all year round.
The disease is transmitted from the person carrying the virus to a healthy person through the respiratory tract or from the mother to the fetus, during the period before and after 1 week of rash. Humans are the only reservoir of pathogens and those who do not have immunity can get rubella. On the contrary, the person after the disease will have sustainable immunity.
Manifestations of common rubella include fever, rash, lymphadenopathy,… but there are still about 20-50% of people infected with the virus asymptom. Although the disease is usually benign, there is still a risk of leading to a few complications such as encephalitis and/or meningitis, thromboembolysis …
2. Rubella in pregnant women
Pregnant women with rubella have similar clinical manifestations to the average person infected with the disease. For women infected with rubella,the most concerning thing is the malformations of the fetus in the womb due to the baby's congenital rubella.
2.1. Incidence of congenital rubella
The risk of transmission from a rubella-infected mother to the fetus is very high, especially in the first months of pregnancy. The incidence of congenital rubella over the duration of a specific pregnancy is as follows:
- First month: From 81 – 90%;
- Second month: From 60 – 70%;
- 3rd month: From 35 – 50%;
- Pregnancy is 13 – 16 weeks: 17%;
- Pregnancy is 17 – 20 weeks: 5%;
- After the 20th week of gestation, the rate gradually decreases to 0-5%.
As such, rubella infection in women in the first 3 months of pregnancy leads to a very high risk of babies having congenital rubella. The statistics also show that up to 25% of children experience malformations as a result of congenital rubella syndrome.
2.2. Rubella treatment in pregnant women
Rubella cannot be vaccinated in pregnant women. Therefore, if you have not been vaccinated before pregnancy, the diagnosis of rubella infection in pregnant women is very important. The steps for examination and follow-up are related to the decision to suspend or hold the pregnancy, namely:
- Pregnant women in the first 3 months of rubella: Counseling to suspend pregnancy when a definitive diagnosis is made.
- During pregnancy from 13 to 18 weeks of rubella infection: Advise on the risk of the baby having congenital rubella, combining amniotic puncture for a definitive diagnostic test. If rubella is found in amniotic fluid, pregnancy suspension counseling; on the contrary, negative cases will continue to monitor.
- Pregnant women over 18 weeks of rubella: Less likely to have congenital rubella, but still need to monitor pregnancy closely.
In particular, women who contract rubella during the first 18 weeks of pregnancy are also very susceptible to miscarriage, still death in the uterus or premature birth. If the child continues to prolong her pregnancy, she will not be able to develop healthy, often underweight, slow to grow, or suffer from poor disease and intellect. Therefore, pregnant women need to go to reliable medical facilities or reputable specialized hospitals to complete the necessary tests, to ensure the safety of both mothers and children.
3. Congenital rubella syndrome
Congenital rubella syndrome is diagnosed definitively in newborns:
- Have had a rash or appeared within 48 hours of birth;
- Pediatric patients have large livers, enlarged spleen, and jaundice…;
- Exploitation of mothers with a history of rubella infection during pregnancy;
- An antibody test in the umbilical cord found both IgG and IgM positive for rubella.
Based on fetal malformations, congenital rubella syndrome is also classified into two groups A and B. Currently, there is no specific treatment, so babies with congenital rubella are only allowed to focus on dealing with complications of the disease. Congenital rubella syndrome can transmit the virus within 1 year or so.
3.2. Risk prevention
Mothers who are pregnant but have not been vaccinated against rubella and are in contact with patients are risk factors for children with congenital rubella syndrome. Moreover, the rate of babies with congenital rubella has also decreased significantly since preventive vaccines are available. Some developed countries have almost ruled out rubella thanks to the vaccination program for children and women of reproduction age (15-40 years old).
Therefore, vaccination for those who do not have immunity to the virus is a simple but effective prevention of rubella disease and congenital rubella syndrome. It should be noted that after pre-production vaccination at least 3 months new women should become pregnant.
In addition, med mother's immunity passed to the child can protect the child within 6 to 9 months after birth. Therefore, it is necessary to vaccinate the child with rubella from the age of 12 months or earlier when there is an epidemic.
As a key area of Share99 Health System, Pediatrics always brings satisfaction to customers and is highly appreciated by industry experts with:
- Gathering a team of leading doctors in Pediatrics:including leading experts, highly specialized (professors, associate professors, doctors, masters), experienced, used to work at large hospitals such as Bach Mai, 108.. The doctors are well-trained, professional, mind-centered, knowledgeable about the child's psychology. In addition to domestic pediatricians, pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) always pioneering the application of the latest and most effective treatment regimens.
- Comprehensive services:In the field of Pediatrics, Share99 provides a chain of continuous medical examination and treatment services from Newborn to Pediatrics and Vaccines,… according to international standards to take care of your baby's health with parents from birth to adulthood
- Intensive techniques:Share99 has successfully implemented many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery – skull, hematoma stem cell transplantation in cancer treatment.
- Professional care:In addition to understanding the young psychology, Share99 also pay special attention to the children's play space, help them play comfortably and get acquainted with the hospital environment, cooperate in treatment, improve the efficiency of medical examination and treatment.
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