Pregnancy and Rubella: Symptoms and Additional Information

Pregnancy and Rubella: Signs and Further Details

Rubella, also known as German measles, is a highly contagious viral infection that can spread through coughing, sneezing, sharing food or drink, and close contact with an infected person. The disease is often mild, but it can have serious consequences, especially during pregnancy.

The symptoms of rubella, when they do develop, are typically flu-like and include a low-grade fever, a rash, loss of appetite, headaches, sore throat, runny nose, cough, pink eye, red eyes, muscle aches, joint pain, swollen glands in the ears and neck. However, up to 50% of people who contract rubella do not develop symptoms, making it easy for the disease to go unnoticed.

If a person tests positive for rubella IgG, the likelihood of acquiring a rubella infection is low. This test measures the immunity to rubella before, during, and after pregnancy. On the other hand, if a pregnant person contracts rubella, the infection can cause congenital rubella syndrome (CRS) in the fetus. CRS can lead to a range of serious health issues for the baby, such as low birth weight, skin rashes, heart defects, liver damage, spleen damage, intellectual disability, cataracts, deafness, lung inflammation, thyroid problems, brain damage, glaucoma, hormonal issues, and miscarriage.

To assess the risk of CRS, serology testing for rubella IgM is used to confirm suspected cases of rubella and identify CRS in newborns and infants. The rash from rubella lasts about 3 days and often starts on the face before spreading to the rest of the body. It may appear light pink or red on white skin and may be difficult to see on brown skin but might feel rough or bumpy.

The rubella vaccine offers protection against the disease for life. However, it is a live virus vaccine and should not be administered during pregnancy or within the 4 weeks before conception according to the CDC. If a pregnant person acquires rubella, treatment during pregnancy often involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

If a pregnant person contracts rubella before 18 weeks of gestation, some clinicians may suggest pregnancy termination due to the likelihood of severe congenital disorders. However, if a pregnant person contracts rubella after 18 weeks of gestation, the fetus may experience less severe effects.

After birth, children with congenital rubella syndrome often have multidisciplinary care teams to address the issues they may experience. The German Society for Gynecology and Obstetrics (DGGG) recommends performing Rubella IgG and IgM serology tests before, during, and after pregnancy to monitor a person's immunity and to detect any potential cases of rubella or congenital rubella syndrome.

In conclusion, while rubella is often a mild disease, it can have serious consequences, especially during pregnancy. It is crucial to be aware of the symptoms, get vaccinated, and follow the recommended guidelines during pregnancy to minimise the risk of complications.