Rubella, commonly known as ‘German Measles’ is a common childhood viral disease that may affect adults as well. More than half of the infections are either asymptomatic or present with mild flu like illness with a typical maculopapular rash. In contrast, primary rubella infection in pregnancy, especially in the first trimester, can have serious consequences, namely miscarriage, intrauterine fetal demise or congenital rubella syndrome (CRS). WHO recognizes CRS as the ‘leading vaccine preventable cause of birth defects’. Antenatal management primarily is based on testing for immunity in the first trimester and recognizing acute maternal infection. A correct interpretation of maternal serology using IgG avidity along with IgM and IgG is imperative to avoid false positive diagnoses. Diagnosis of fetal infection is by detection of Rubella virus specific RTPCR in amniotic fluid and is indicated if maternal seroconversion is seen in the periconceptional period and/or the first trimester or if there are ultrasound features suggestive of fetal infection. Since there is no treatment available to either prevent mother to child transmission or to treat fetal infection, the mainstay is prevention. India is amongst the 11 countries of WHO South East Asia Region who are committed to control of Rubella and CRS by 2020.
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Singh, C. Rubella in Pregnancy. J. Fetal Med. (2020). https://doi.org/10.1007/s40556-019-00238-2
- Congenital rubella syndrome