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Confirming the diagnosis of Rubella

It is important to confirm (by doing the appropriate test) whether what a pregnant woman has been exposed to is indeed Rubella. This is because a few other infections do have symptoms similar to Rubella.

If it is established that she was exposed to Rubella and that she has acquired the infection, the mother is faced with the difficult decision of terminating the pregnancy or taking chances with it. Unfortunately, most babies exposed at the early stage of pregnancy will be affected.

Exposure to Rubella in late pregnancy

The proportion of babies affected if exposure is in late pregnancy is reduced and so is the severity. Nonetheless, infection should be confirmed, using a blood test.

The obstetrician should then discuss with the mother whether she wants to have an invasive test to check whether the baby has been affected as well. Many probably wait to have this done after delivery.

If infection of the baby is confirmed, monitoring of the growth and general health of the child are all that is required.

Some features of congenital rubella syndrome appear late. These may include:

· Thyroid dysfunction

· Diabetes

· Abnormally early puberty (precocious puberty).

Rubella vaccination during pregnancy

Rubella vaccination should never be given to a pregnant woman. However, if this is inadvertently done, no action needs to be taken. There has been no recorded adverse effect as a result of vaccination in pregnancy. Having said that, no deliberate vaccination should be carried out in pregnancy.

Reducing the severity of rubella infection during pregnancy

Nothing can be done to achieve this. Even though there is an immunoglobulin preparation to confer passive immunity to exposed individuals, this is not recommended for administration in pregnancy. This is because it is known not to prevent fetal infection and there is no evidence that it could reduce the severity of the effects of the infection to the fetus.

Just remember, most adult women will be immune to Rubella either through childhood vaccination or previous infection.