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Exposure to Measles  (Rubeola) during pregnancy



In the United States, like in most developed countries, measles has been virtually eliminated following the policy of compulsory vaccination. Before the introduction of vaccination in the mid-1960s, there were over half a million cases of the infection annually. In 2004, there were only 37 cases throughout the country. The risk is therefore very small indeed.


If you become exposed to measles while you are pregnant, don't panic. That is the first thing.


Most adults of child­bearing age will either have been vaccinated sometime in their childhood or would have had the infection. The immunity acquired from either is life-long and 95 % of all those who are vaccinated acquire this immunity.


This leaves only a small minority who may be susceptible during pregnancy. If you are unsure whether you have had the infection or been immunized, then you should contact your doctor promptly after exposure to have your status checked. If no records are available, then a simple blood test may establish whether you are immune or not.


If you are susceptible, an injection of a protective protein (immunoglobulin) may be administered to give you passive immunity. The protection from this is not total, but even if you go on to get the infection, it will be attenuated and therefore mild.



Exposure to measles without being aware

Of-course it is possible to be exposed to measles without being aware. Again, this is a very rare occurrence, for the reasons explained above. However, when this happens, the infection can be serious, needing hospital admission and isolated nursing.


Measles pneumonia, which may be complicated by secondary bacterial pneumonia, is the most likely problem. The potential complication of measles infection in pregnancy is that it could provoke labor and lead to premature delivery. If this happens, attempts may be made to suppress the contractions, provided the mother is not too ill and there are no features of fetal distress. Efforts to suppress labor are not always successful.


Measles  vaccine during pregnancy

Vaccination for measles employs a live (weakened) virus and no such vaccination can be given during pregnancy.


Inadvertent vaccination against Measles during pregnancy

It is essential to check a woman’s menstrual history before vaccinating her against measles or any other infection for that matter. Some will go so far as to perform a pregnancy test, to avoid any mishap. However, cases of vaccination during pregnancy have been reported. No adverse effects to the babies have been observed and therefore, even in such an accident, there is really no question of recommending termination of pregnancy.



Measles rash

A typical measles rash

By Dr Joe Kabyemela, MD