Rubella in Pregnancy

image001Rubella infection, also referred to as German measles, is brought about by the rubella virus and while it is mostly identified in small children, the virus can affect any of us. Before the Rubella vaccination was developed in 1969, there were 12.5 million cases of the disease in 1964-1965 Rubella epidemic and 20,000 cases of CRS in the United States. Now, Rubella in pregnancy is uncommon in the U.S. and in UK thanks to the vaccination programme. However, they are still common and pose great risks in developing countries. 

The virus is usually non-threatening to adults but if you are expectant, the virus could pose as a serious risk to the unborn child.  There is an immunization which you can take before becoming pregnant.

Why Do You Have to Be Immunue Against Rubella in Pregnancy?

Medical professionals advocate for rubella immunization before pregnancy due to the high risk it poses to the child. There have been cases of developmental problems, birth defects and even miscarriages associated with rubella. CRS also known as congenital rubella syndrome is a name used to identify the problems caused when an infant is born with rubella. 

Know How CRS (Congenital Rubella Syndrome) Harms Your Baby

The greatest rubella risk occurs in the early developmental stages of the baby’s life and the risks decrease as the pregnancy advances. If you are infected with rubella within the first 3 months, chances of your baby developing CRS are high – as much as 85%. The risk reduces to 54% if the mother is infected between the third and fourth month. After 5 months, the risk of a birth defect is reduced greatly. Some of the common problems that are associated with CRS include eye defects and possible blindness, deafness, neurological problems and heart malformations. While some defects may be identified at birth, others will develop in infancy or at childhood.

These consequences as you can see are quite dire but, it’s important to remember that the risk of rubella is very low in the U.S. However, it is still important to get tested as this reduces all of the risks we just highlighted.

When Should You Get Rubella Immunity Test?

Immunity from rubella cannot be downplayed, even if you had the vaccination in school. You can only know if you are immune to Rubella by having a blood test.  If you were not screened before getting pregnant, you will have the test on your first prenatal visit. The vaccine is recommended before pregnancy. 

Unfortunately, you cannot get the vaccine while pregnant and this is because the vaccine has a live virus and this may cause the infection to occur. It is for this reason that you are advised not to get pregnant within a month of getting the vaccination.

What Are the Rubella Symptoms?

Rubella symptoms include: joint pains, headache, fever, sore throat and swelling glands which are accompanied by a pink rush.

What to Do If You Are Exposed to Rubella in Pregnancy?

The first action to take would be seeking medical help. However, you should call your doctor in advance and not just show up at the healthcare center unannounced. This puts other expectant mothers at risk and the doctor will make special arrangements for you to avoid infecting others.

If you were immune to rubella when exposed to the virus, the risk of re-infection is minimal and it is unlikely that your baby will be infected. Although further testing might not be required, it is still important to seek immediate medical attention.

If you contract rubella during the early stages of pregnancy, you will need to visit a maternal-fetal medicine specialist. Since there is no treatment or effective mother-child transmission prevention known, you might be forced to decide on whether or not you should terminate the pregnancy. If you decide to keep the pregnancy, the doctor will give you an immune globulin shot with the hopes of reducing the risk of the baby developing defects. That said, the shot does not prevent infection from passing onto the baby.

How to Reduce Your Risks of Being Exposed to Rubella

If you are not immune and pregnant, you need to be very careful. Avoid people with rushes or the virus and others that have been exposed to it. Important precautions to take are:

  • Postponing trips to countries where there is a high risk of rubella, avoiding contact with anyone who has had the infection and ensuring that your children, as well as anyone around them at home is immunized.
  • When you give birth, get the vaccine to avoid the risk of rubella in your next pregnancy. The good news is that you can get the vaccine even while breastfeeding.
  • As mentioned earlier, you need to avoid getting pregnant within a month or 28 days of getting the injection. If you do get pregnant, the risk of rubella harming your child is low but, you still need to be very cautious.

What Do You Need to Know About Rubella Vaccination?

As mentioned earlier, Rebella is uncommon in U.S. or UK; the risk of infection is still high in other countries which means that you could get infected by visitors or U.S residents who travel to high risk countries without getting vaccinated. Thus, adults are recommended to get an MMR vaccination, especially when you are trying to get pregnant.

The MMR vaccine protects you from not just rubella but measles and mumps as well. In children, 2 doses are administered with the first at 12-15 months and the second one before going to school from age 4-6. Another vaccination you can take is MMRV which is effective in preventing rubella, measles, varicella (chickenpox) and mumps. Vaccinating your young one helps protect them from getting the infection.

It's good to know that about 90% of the children aged above 5 years of age are immune to the virus. This is probably due to immunization or the fact that they were already treated as children. It’s important to note that rubella (German measles) and rubeola (regular measles) are not one and the same. If you have immunity from one virus, you are still at risk of contracting the other.

This video talks about the importance of getting the Rubella vaccine and the consequences of the infection on pregnant women who are not immune. Watch it for more information on rubella.