Rubella in pregnancy
Rubella is a classic and highly contagious childhood disease that can lead to epidemics in kindergartens and hospitals. Rubella only affects humans and, after infection, causes lifelong immunity to this virus.
Infection with rubella during pregnancy
Infection with the rubella virus from the togavirus family occurs via droplet infection. The viruses migrate to the lymphatic system and multiply there. It can take two to three weeks from the time of infection to the outbreak. If you have already contracted rubella as a child, you do not need to worry about an infection with the rubella virus during pregnancy. Since the body has formed antibodies against this pathogen after surviving an illness, you are safe from being infected again. However, if an initial infection occurs during pregnancy, it can cause serious damage to the child. Because the viruses can penetrate through the placenta to the child.
Risks of rubella in pregnancy
About 10 to 15 percent of women in Germany have not developed antibodies against rubella. If you contract rubella during pregnancy, this can have serious consequences for the unborn child. Especially up to the 17th week of pregnancy, a rubella infection in the fetus can lead to heart defects, blindness and deafness. Unfortunately, in the first month of pregnancy, the rate of malformations in infected fetuses is 50 to 60 percent. The probability of severe damage is highest between the 11th and 17th week. In the case of an infection with rubella after the fourth month of pregnancy, however, only 20 percent of the fetuses are infected and only 3.5 percent develop malformations.
Possibilities of prevention and prenatal diagnostics
- Active rubella vaccination in girls during puberty is an attempt to create immunity in women before a possible pregnancy. If you get vaccinated against rubella before planning a family, you should wait three months after the vaccination before you become pregnant.
- In Germany, general screening for rubella antibodies is part of prenatal care. With this examination, the so-called titer value, which indicates the rubella antibodies, can be detected in the blood and it can be determined whether the pregnant woman has sufficient antibodies against rubella.
- If a pregnant woman comes into contact with the rubella virus and does not have adequate protection, she can be injected with rubella immunoglobulins within seven days, which are intended to prevent infection.
- If necessary, an infection in the child can also be detected with invasive prenatal diagnostic measures. For this purpose, the doctor can take a direct sample from the child through a chorionic villus biopsy or amniotic fluid test. From the 22nd week of pregnancy, an examination of the fetal blood would also be possible.
Symptoms of rubella in pregnancy
The typical sign of rubella is the patchy rash that spreads from the face all over the body. It is often accompanied by fever and swelling of the lymph nodes. Headaches, joint pain and joint swelling can also be side effects of rubella.
Treatment of rubella in pregnancy
There is no effective therapy for rubella, neither for the pregnant woman nor for the child. Only the symptoms can be alleviated. If an illness is suspected, the pregnant woman can therefore only be administered immunoglobulins within the first few days in order to possibly prevent an infection.