Congenital Rubella

Congenital Rubella is a viral infection that is transmitted during pregnancy from the mother. Consequences can be multiple abnormalities that lead to the death of the fetus. The diagnosis is made serologically or by virus isolation. There is no specific treatment. Prevention is only by vaccination.

Congenital Rubella is a viral infection that is transmitted during pregnancy from the mother. Consequences can be multiple abnormalities that lead to the death of the fetus. The diagnosis is made serologically or by virus isolation. There is no specific treatment. Prevention is only by vaccination.

(Rubella.) Congenital Rubella is a viral infection that is transmitted during pregnancy by the mother. Consequences can be multiple abnormalities that lead to the death of the fetus. The diagnosis is made serologically or by virus isolation. There is no specific treatment. Prevention is only by vaccination. Congenital rubella are mostly based on a primary disease of the mother. Congenital rubella are rare in the United States. Rubella penetrate the nasopharyngeal space and colonize a viremia different places, including the placenta. The fetus has the highest risk for the development of congenital malformations in the first 16, but especially in the first 8-10 weeks of pregnancy. It is believed that the virus causes a chronic intrauterine infection in the early stage of pregnancy. This leads to endothelial damage to the blood vessels, direct cytolysis of cells and disruption of the mitotic cell division. Symptoms and complaints rubella may be asymptomatic or manifest as infection of the upper respiratory tract, conjunctivitis, lymphadenopathy (especially suboccipital and behind the ears) and a maculopapular dermatitis in pregnant women. In the further course, it can also cause joint pain. The fetus itself can happen either nothing or he dies in utero or he developed several anomalies that are part of the syndrome of congenital rubella (CRS). The most common abnormalities include intrauterine growth retardation microcephaly meningoencephalitis cataract retinopathy hearing loss heart defects (patent ductus arteriosus and Lungenarterienstenose) hepatosplenomegaly bone radiolucency to the less widely manifestations include thrombocytopenia purpura, a dermal erythropoiesis with resulting blue red skin lesions, adenopathy, hemolytic anemia and interstitial pneumonia occur , Patients should be continuously monitored because of the possibility of later deafness, mental retardation, development of behavioral problems, endocrine disorders (eg. As diabetes mellitus) or the rare progressive encephalitis. Infants with congenital rubella can immune deficiencies such as hypogammaglobulinemia develop diagnostic Maternal serum rubella titer Viral mother study of culture and / or reverse transcriptase PCR (RT-PCR) of amniotic fluid, nose, throat (preferred), urine, cerebrospinal fluid or blood antibody titers (serially measured) of the infant and virus detection in pregnant women should be determined in early pregnancy routine rubella IgG titer as above. In women who show signs or symptoms of rubella infection, the titer is measured repeatedly. The diagnosis of maternal infection is provided by a positive serological test for IgM antibodies or IgG seroconversion, or after a ? 4-fold increase in titer between-the acute phase of the disease and convalescence. The virus can be isolated by nasopharyngeal swabs, but cultivation is difficult. Reverse transcriptase PCR (RT-PCR) can be used to confirm culture results or detect a viral RNA directly from patient samples and to allow genotyping and epidemiological tracking of wild-type rubella infection. In infants with suspected CRS antibody titer and samples for viral detection should be removed. Persistent rubella specific IgG antibodies after 6-12 months suggest a congenital infection. The detection of rubella-specific IgM antibodies soricht usually for rubella, but fasch-positive IgM results occur. Samples from the nasopharynx, urine, cerebrospinal fluid, buffy coat and conjunctiva of infants with CRS usually contain viruses; Samples from the nasopharynx provide the best sensitivity to the culture in general. However, the laboratory should be pointed out that rubella is suspected. In some centers, the diagnosis by the detection of the virus in the amniotic fluid, rubella specific antibodies in the fetal blood by RT-PCR in the fetal blood or in Chorionzottenbiopsaten can be found prenatally. Other tests include a complete blood count, CSF examination and X-ray examinations of the bone to detect characteristic bone permeabilities. A thorough ophthalmic and cardiac examination is often useful. Treatment advice may immunoglobulin for the mother There is no specific treatment for maternal or fetal rubella infection. Pregnant women who had contact with rubella should be informed of the potential risk to the fetus. Some experts recommend the use of non-specific immunoglobulin (0.55 ml / kg i.m.) for exposure in early pregnancy. However, this treatment does not prevent infection, and the use of immunoglobulin should be considered only in women consider who reject a termination of pregnancy. Prevention Rubella can best be prevented by vaccination. In the US rubella be vaccinated with measles and mumps at the age of 12-15 months. A booster is done before school entry or during transfer to the high school (Kindheitsimpfplan). Postpubertal non-pregnant women who are not immune to rubella should be vaccinated. (Note: The rubella vaccine is contraindicated in immunocompromised or pregnant women.) After vaccination, women should be advised not to become pregnant within the next 28 days. There should be efforts to vaccinate high-risk groups such as hospitals and child care staff, soldiers, fresh Immigrant and students. Women who are judged to be vulnerable during prenatal care should be vaccinated after delivery and before discharge from the hospital. Theoretically, the vaccination of immune people could exposed rubella infection to prevent, if carried out within 3 days after exposure, but this treatment does not prove to be beneficial. People with documented vaccination with at least one dose of live attenuated rubella virus vaccine after the age of 1 year or that have a serological evidence of immunity to rubella, can be considered immune. Important points maternal rubella infection, especially during the first trimester can cause intrauterine growth restriction and severe developmental disabilities. The routine rubella vaccination has made rare congenital rubella in the United States. The rubella vaccine is contraindicated in pregnancy, therefore should pregnant women with rubella or who are exposed to these, be informed of the potential risk to the fetus.

Health Life Media Team

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