Rubella and pregnancy

Rubella and pregnancy

Sevostyanova Oksana Sergeevna

Rubella is an acute infectious disease caused by a virus. Main manifestations of rubella are: mild skin rash, increased occipital and posterior cervical lymph nodes, fever, headache, muscle pain. Rubella virus is unstable in the environment, very sensitive to temperature and chemicals.

Transmission occurs through airborne droplets (sneezing, coughing, conversation). For infection requires a sufficiently long and close contact with to the sick (caring for a sick child, sharing a room, etc.), but since rubella often proceeds covertly when a particular contact has occurred may be unknown.

Rubella is a childhood infection, but adults also suffer from it, especially during recurrent (especially in spring) epidemic outbreaks.

The incubation period lasts 15-21 days.

Rubella in children

In children, the disease is relatively easy. Begins acutely with the appearance on the skin of a pale pink, mottled rash that does not rise above the surface skin size up to 3-5 mm. The rash first appears on the face, spreads quickly. throughout the body, especially many elements on the back, buttocks, internal surfaces hands and feet. On the palms of the rash does not happen. Later may increase posterior cervical and occipital lymph nodes, a slight increase in temperature, inflammation of the upper respiratory tract and as a complication - inflammation of the joints.

For rubella in adults

In adults, the disease is usually much more severe. Rash may precede the phenomenon in the form of general malaise, headache, chills with an increase temperatures up to 38 °, joint pain, runny nose, sore throat and, as a rule, general increase in lymph nodes, especially the posterior cervical and occipital.

The most common complication in adults is damage to the small joints of the hands, which occurs in a third of cases. The most difficult, though rare, complication - This is a brain injury - encephalitis.

Rubella is not a highly contagious disease, but has not had a history of it in the past. rubella pregnant women who have been exposed to a large number of children (for example, employees of children's institutions, schools, hospitals), among which may be sick rubella, including those with hidden flow, put themselves at great risk infection.

The effect of rubella on the fetus

During pregnancy, the virus in the mother’s blood infects the embryo’s tissues, causing chronic infection of the fetus in the first three months of pregnancy, violating his prenatal development, often leading to spontaneous abortion (miscarriage).

The frequency and extent of fetal damage is largely determined by the period pregnancy at the time of infection. The shorter the gestation period at which the woman contracted rubella, the more often and more severe malformations develop in the fetus. The most dangerous first trimester of pregnancy (from conception up to 12 weeks). During this period, all important organs develop. fetus.

The defeat of the fetus by the rubella virus is diverse, and the extent of the lesion is not depends on the severity of the disease pregnant.

Signs of congenital rubella in a newborn:

  1. Eye damage.
  2. Heart defects.
  3. Deafness.
  4. Brain affection.
  5. Skeletal malformations.
  6. Malformations of the liver and spleen.
  7. Malformations of the urinary organs.


The defeat of the nervous system is not always diagnosed at birth, as it can manifest much later in the form of seizures, mental underdevelopment.

Rubella-infected children, even those with no developmental disabilities, are often born. with small body weight and small growth, and further lag behind in physical development.

In addition to the development of malformations in the fetus, there may be other types of complications. pregnancy: miscarriage, stillbirth.

With rubella may cause complications during childbirth: violations of labor, bleeding, sepsis (blood poisoning).

Diagnosis of rubella

With a typical clinical picture, confirmed by a specific contact, diagnosis rubella is not difficult.

Great importance is the contact with non-rubella and unvaccinated before pregnancy women with rubella patients (caring for pregnant women for sick children, work in children's collectives during an outbreak of infection).

Laboratory tests are needed to confirm rubella infection:

  • virus isolation from the nasopharynx usually 2-3 days before the rash by seeding on nutrient medium;
  • positive blood reaction with rubella antigen.
  • isolation of rubella-specific LqM antigen from the blood.

If the diagnosis of rubella remains doubtful, especially in cases where the contact took place at an early gestational age, then at 14-20 weeks you can spend amniocentesis and try to isolate the virus from the amniotic fluid.

Diagnosis of congenital rubella

Suspected congenital rubella in children may be based on:

  • the presence of one or more signs (see above) in a newborn;
  • confirmed or suspected rubella mother's disease during pregnancy;
  • isolation of the virus from the contents of the nasopharynx, urine, cerebrospinal fluid, especially in the first three months of life;
  • isolation of the rubella-specific LqM antigen from cord blood soon after birth, indicating intrauterine infection;
  • the presence of antibodies to rubella at the age of 6 months, especially against the background of clinical manifestations, as a newly acquired infection in early childhood age does not occur.

Rubella treatment

Rubella does not require specific treatment.Isolation, bed rest is shown. When complications prescribe:

  • analgesics;
  • sulfa drugs;
  • According to the indications of antibiotics, gargling with antiseptic solutions.

The introduction of the human gamma globulin pregnant after possible contact in order to prevent infection of the fetus is not recommended, as it does not prevent damage to the fetus, but only facilitates the course of the disease.


Indications for abortion:

  1. Confirmed data on the incidence of rubella in the first trimester and even up to 16 weeks of pregnancy, regardless of the severity of the disease, are indications for artificial interruption of pregnancy at up to 16 weeks.
  2. With positive laboratory tests, the pregnancy is interrupted at term. up to 16 weeks even in the absence of clinical manifestations, given the possible hidden course of the disease.
  3. If a disease is detected or a fetus is suspected, if pregnant got sick for more than 16 weeks, abortion up to 28 weeks is indicated.
  4. For rubella after 28 weeks, pregnant women are taken into account at high risk.Further preventive measures are taken. on fetal protection, treatment of placental insufficiency, prevention and treatment non-wearing out.
  5. If there are signs of congenital rubella in a newborn or suspicion it should be thoroughly examined as soon as possible. Further the child must be constantly monitored by appropriate specialists.

Rubella prevention in pregnant women

It is necessary to know that women who have suffered rubella form a persistent and prolonged immunity. Pregnant women who did not have rubella before pregnancy, Contact with rubella patients should be avoided, this applies especially to employees. institutions, in cases of caring for a sick child in the family, etc. outbreak of rubella should be avoided at all visits to children's groups and crowded places: cinemas, clinics, etc.

Until recently, in the CIS, including Ukraine, active immunization (vaccination) against rubella was not carried out. Currently in various countries, including Ukraine, certain age groups are allowed and it is recommended to apply several different types of live attenuated vaccines. rubella virus.

If you haven't had rubella, i.e. You are not 100% sure of this (such confidence can only give documentary evidence), then vaccination needs to be done 2-3 months before the planned pregnancy. All modern anti-feathers vaccines have 95-100% efficiency, and the immunity they have created remains more than 20 years. Vaccination consists of just one vaccination, since the vaccine is a live virus, i.e. Immunity is formed immediately and for a long time. One more The positive effect of vaccination is the transmission of rubella antibodies to the maternal milk

In no case should this vaccine be given during pregnancy because of theoretical, but still the likelihood of damage to the fetus vaccine virus. After vaccination must be protected from pregnancy for 2-3 months and only after this term plan conception.

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  • Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy

    Rubella and pregnancy