Rubella in pregnant women has consequences for the fetus. Features of the treatment of rubella in pregnant women

Rubella is a viral infection that is usually mild and does not cause complications in either adults or children. However, during pregnancy, the rubella virus is very dangerous, as it can penetrate the placenta and infect the fetus. Infection with rubella during pregnancy can result in its termination or the birth of a child with serious abnormalities.

Fortunately, rubella during pregnancy Lately doesn't happen that often. Children are vaccinated against rubella, and many adults have already had it in childhood and have earned lifelong immunity. In countries where a small part of the population is covered by vaccinations, there are higher rates of morbidity among pregnant women, for example, in Africa and Southeast Asia.

However, the risk of contracting rubella during pregnancy still exists, especially for those women who deal with children, for example, work in kindergartens, clinics, and schools. Susceptibility to rubella is quite high and therefore the risk of getting sick from contact with a sick person is high.

Is it possible to become infected with rubella again during pregnancy? There is such a risk, but it is negligible. There have been cases in medicine where a woman, having been ill or vaccinated against rubella, became re-infected with this infection.

But in this case, the likelihood of transmitting the infection to an unborn child is tens of times lower than if the woman had no immunity at all. Nevertheless, doctors advise avoiding contact with people with rubella during pregnancy, even if you have immunity to it.

Rubella during pregnancy: symptoms.

Rubella infection occurs through airborne droplets. From infection to the appearance of the first signs it can take from 11 to 24 days.

Rubella during pregnancy is manifested by the following symptoms: fever, runny nose, cough, rash, enlarged cervical and occipital lymph nodes, red eyes. The rash with rubella is pink, small, appears first on the face, but within a few hours spreads throughout the body.

The rash lasts no longer three days, then passes without leaving a trace. Sometimes rubella during pregnancy occurs without rashes, and is very similar to a common acute respiratory infection, so it is not always possible to diagnose it only by symptoms.

If a pregnant woman shows signs of infection or has had contact with someone with rubella, she should immediately consult a doctor. In some cases, immunoglobulins are administered, which reduces the risk of damage to the fetus.

Rubella during pregnancy: consequences.

Rubella during pregnancy can have fatal consequences for the unborn child. The rubella virus, penetrating the placenta, infects embryonic tissue.

Infection of the fetus in the first trimester in most cases leads to either its death, that is, miscarriage, or to the development of congenital rubella syndrome (CRS). CRS is manifested by severe developmental defects - deafness, blindness, heart and brain defects, mental retardation, cerebral palsy.

On early stages pregnancy, the probability of fetal infection is 80%. After 12 weeks of pregnancy, the risk decreases to approximately 25%. If you contract rubella during pregnancy after the 20th week, the likelihood of having a child with abnormalities is almost zero.

If rubella infection occurred several weeks or even days before conception, then this does not pose a danger to the unborn child.

Is it necessary to terminate a pregnancy in case of rubella during pregnancy? In Soviet medicine, rubella in the first and second trimester of pregnancy was considered an indication for abortion. But now some doctors believe that even if the mother shows signs of rubella, this does not mean that the pregnancy should be terminated.

There are certain diagnostic methods that allow you to assess the condition of the fetus and, possibly, avoid termination of the desired pregnancy. Of course, the longer the pregnancy, the greater the chances of a favorable outcome. Rubella poses the greatest danger to the unborn child during pregnancy up to 16 weeks.

Test for rubella during pregnancy.

Testing for rubella during pregnancy is recommended for all women in the first trimester. Antibodies to rubella (Rubella) are of two types: IgG, the so-called mature antibodies, and IgM, antibodies that appear in the blood after the introduction of the pathogen and indicate an active infectious process.

In the absence of symptoms of active infection, only a test is taken to determine the level of IgG antibodies to the rubella virus in the blood serum. If the result is positive, then the woman has protection against rubella, the risk of re-infection is almost zero.

If the result is negative, you should avoid contact with sick people. The rubella vaccine contains live rubella virus, so this vaccine should not be given during pregnancy! It is necessary to follow preventive measures and consult a doctor if there are any signs of infection.

Since children are more likely to get rubella, it is better to avoid going to places where there are children. If you have an older child, then there is a high probability that he will bring the virus from kindergarten or school, so it is imperative that your child is vaccinated. After vaccination, the child is not contagious.

Vaccination against rubella before pregnancy.

It is best to take care of protection against rubella at the stage of pregnancy planning. The first thing to do is find out if you have immunity to this disease. To do this, a blood test from a vein is taken for IgG antibodies to the rubella virus. If the result is positive, then you are immune.

If there are no antibodies to the rubella virus, you need to get vaccinated. Modern vaccines contain live rubella viruses, so it is not advisable to become pregnant after vaccination. Most doctors recommend planning a pregnancy 2-3 months after vaccination. But if you accidentally become pregnant earlier, then you should not terminate the pregnancy, the risk is theoretical.

If a woman was vaccinated at the very beginning of pregnancy, without yet knowing about it, then termination of pregnancy is also not recommended. So far, no cases of congenital rubella following accidental vaccination of a pregnant woman have been described.

So, in the case of rubella during pregnancy, avoiding serious problems with the child’s health and unnecessary worries is quite simple, but you need to take care of this in advance.

Rubella is an airborne disease. If it goes into childhood, it has virtually no effect on the body. But rubella during early pregnancy is very dangerous for the fetus: through the mother’s blood, the virus reaches the child and affects its development processes, leading to serious pathologies of tissues and skeleton. Mom may feel great, but this does not inspire hope. What is the cause of the disease? How to protect yourself from it?

Read in this article

Where does rubella come from?

The disease spreads by airborne droplets. The virus enters the mother's body mainly from children. That is why it is especially dangerous to carry a child in a family where there is another baby who attends a kindergarten or other places with a large number of children.

The mechanism of penetration into the body is as follows:

Penetration of the virus through the respiratory tract.
Reproduction of rubella in the lymph nodes.
Penetration into the blood a week after infection.
Increased vascular permeability, tissue swelling.
, cough, runny nose, rash, damage to skin blood vessels.
The formation of antibodies from the third day after the appearance of the rash.
Persistent and long-lasting immunity.

Why is the disease dangerous for the fetus?

Rubella and early pregnancy are a terrible combination. In 80% of cases, this leads to damage to the child, which can result in (in 30% of cases), (in 20% of cases), as well as the death of the newborn (20% of cases). In case of survival, cataracts, deafness and heart disease are identified, often all three diseases at the same time, and they are called the Greta triad. Quite often, pneumonia is diagnosed in a newborn, problems in the circulatory system, spleen, bone tissue, low body weight and short stature. In the future, children with congenital rubella experience mental retardation, paralysis, increased nervous excitability, convulsions, hyperkinesis, etc.

Duration of maternal infection	Consequences for the child
2-7 weeks	Fetal death and abortion
2-6 weeks	Glaucoma, cataracts, microophthalmia, retinopathy
5-7 weeks	Heart defects, congenital deformities
5-12 weeks	Damage to the inner ear and hearing
8-9 weeks	Malformations of baby teeth

In 60% of cases, organ damage occurs from 2 to 4 weeks of pregnancy, in 30% from 5 to 8 weeks, in 10% of cases from 9 to 12 weeks. This is why it is especially dangerous to catch the disease in the first trimester. From the second, the likelihood of getting such serious consequences decreases, however, even at 5 months the disease will not go away without a trace for 1 out of 10 children. The organ that is developing most actively at this stage will suffer the most. In 70% of cases, the disease affects the hearing organs.

It is worth noting that rubella during pregnancy is later may have a negative impact on labor activity in the form of bleeding, blood poisoning, weakness of labor.

If the virus infection occurs after the 20th week, then the risk of pathologies in the fetus is significantly reduced, but is not completely eliminated. Disorders of the nervous system and damage to the hearing organs are possible in the future. After 28 weeks, doctors will not recommend terminating the pregnancy, but will make every effort to exclude placental insufficiency. Additionally, the mother will be prescribed antiviral therapy and a vitamin complex. The pregnant woman will be registered as a woman at risk.

Doctors also note the fact that until 2001 in Ukraine, for example, there was temporarily no vaccination against this disease. Therefore, about 30% of women of childbearing age can potentially experience it during pregnancy. Unfortunately, if the mother’s doctors have diagnosed symptoms of rubella during early pregnancy, she will have to make a choice - either, or hope that everything will work out.

Symptoms of rubella and its manifestations

Pregnancy and rubella, the symptoms of which may go unnoticed in some cases, are still incompatible. Unfortunately, the disease will not pass without a trace for the child. How exactly the virus manifests itself in the body will be influenced by the state of the mother’s immunity, as well as the type of virus.
The disease develops within 5 to 25 days from the moment of infection without symptoms, and only then does a rash appear. Much less often, but already from the first days, pregnant women may begin to complain of:

frequent;
deterioration;
weakness, poor health;
runny nose;
redness of the throat.

A few days after the onset of the disease, the temperature may rise slightly, and already with the appearance of the rash it will rise to 39 C. Also, the sick person will have enlarged lymph nodes (behind the ears, on the neck and in the back of the head), and when pressing on them, the pregnant woman will feel pain.

How is the presence of the virus diagnosed?

It is worth noting that if the expectant mother had rubella in childhood, then the likelihood of becoming infected again is extremely low, since antibodies are produced in the body. The same applies to mothers who suffered from the virus before pregnancy. Everyone else will be recommended to take a test for TORCH infections, the results of which will reveal immunoglobulins (IgG and IgM).

Moreover, IgM is an index of the presence of the virus, which manifests itself from the onset of the disease and reaches its maximum amount by the third week. If antibodies were not detected, this may indicate that either the pregnant woman did not have rubella and does not have it now, or that she suffered from the disease a very long time ago. More detailed information in this case will give a second immunoglobulin IgG. It is a lifelong indicator of the presence of antibodies in the body. If it is not detected in the blood, then the woman has not yet encountered the disease. If a pregnant woman becomes infected with the virus, the maximum rate will be a month later.

When, after analysis, the presence of IgM without IgG is established, then in this case I recognize the onset of the disease. If high levels of both antibodies are detected, then the virus is in full swing. It is easier to understand whether rubella is present during pregnancy from the table:

Meaning of the results	IgM	IgG
There is no immunity to the rubella virus	—	—
There is immunity to rubella	—	+
Acute rubella, early period	+	—
Acute rubella	+	+
Vaccination required	—	—

What to do if there are first signs of illness

If the expectant mother had contact with sick people or found out that the child got sick a week after the contact, she must visit an infectious disease specialist and a gynecologist. The first one will send you for a blood test, and the second one will send you for an ultrasound, and will also advise you to undergo a “triple test” (from the second trimester). Based on the results obtained, a decision will be made to continue or terminate the pregnancy.

In the first trimester, everything usually ends in abortion. After 28 weeks, doctors will administer immunoglobulin (20-30 mg) to the mother, and will also carry out a set of procedures aimed at protecting the fetus, preventing placental insufficiency and maintaining pregnancy.

Prevention against rubella virus

Even if a woman has already suffered from the disease, it is still recommended to carry out prevention methods. After all, reduced immunity can provoke re-infection. To do this, doctors insist, even at the planning stage, on taking a test to detect antibodies to the virus and, if they are absent, on vaccination.

The vaccine that will be administered to the expectant mother, based on living bacteria. Its effectiveness is 100%, and protection lasts for 20 years from the date of administration. However, there are contraindications for routine vaccination:

long-term treatment with hormonal drugs;
immunodeficiency;
recent radiation therapy;
individual intolerance to neomycin;
pregnancy.

It is worth noting that after the vaccine is administered, it is not recommended to plan a child for three months. Additionally, it is recommended to undergo tests to confirm the production of antibodies. However, if pregnancy has occurred, it will not be interrupted, since the risk of damage to the fetus is possible only in 2% of cases.

Useful video

Watch this video about the dangers of rubella during pregnancy:

Rubella during pregnancy is dangerous due to intrauterine infection of the fetus, which threatens the development of congenital deformities. Every year, up to 300 thousand newborns with congenital rubella syndrome (SLE) are born around the world. In Russia, among all children born with deformities, 15% are deformities associated with this disease. The situation is aggravated by the fact that about 90% of all cases of rubella occur without visible symptoms. The frequency of fetal damage depends on the stage of pregnancy. Vaccination against rubella in adolescent girls and young women who do not have immunity will help minimize the birth of children with SLE.

Rubella occupies a leading place among airborne infections of a viral nature. The disease is characterized by symptoms such as a small-spotted rash and enlarged cervical lymph nodes (often occipital). Most often, the disease affects children 3–9 years old. IN last years There is an increase in incidence among adults.

Rice. 1. The photo shows congenital rubella. Cataract is one of the common manifestations of SLE.

Why is rubella dangerous during pregnancy?

The developing fetus during the first trimester of pregnancy is most vulnerable to rubella viruses if the pregnant woman does not have immunity to the disease. Viruses can enter the fetal blood through the placenta and cause many serious developmental defects.
Rubella in pregnant women causes miscarriages and stillbirths in 15% of cases.
With congenital rubella, the viruses in the child’s body persist for 1 to 2 years, and therefore the newborn poses an epidemic danger to others even if there are protective antibodies in the blood.

How dangerous is the rubella virus during pregnancy?

The rubella virus is transmitted to pregnant women in two ways: from a sick person and from a sick pregnant woman to the fetus.

Viruses are transmitted by airborne droplets, which contributes to the rapid spread of infection in organized groups. The disease occurs only with close and prolonged contact, unlike chickenpox and measles.
Rubella viruses during pregnancy are able to penetrate through the placenta into the blood of the fetus, damaging its genetic apparatus and destroying cells. In women who suffered from rubella while in the 3rd to 4th week of pregnancy, from 50 to 85% of cases of birth of children with congenital deformities are registered.
Rubella viruses in newborns who have had the disease in utero are released into the external environment through nasopharyngeal mucus, feces and urine for many months. The child poses a great epidemiological danger to others.
Rubella viruses during pregnancy begin to be released into the external environment from the patient several days before the appearance of the rash and continue to be released for a week after its appearance.

Rice. 2. Rubella during pregnancy in the first trimester poses a great danger to the fetus.

Rubella in pregnant women: symptoms of the disease

Rubella during pregnancy occurs in typical, atypical (without rash) and inapparent (asymptomatic) forms. Asymptomatic forms account for up to 90% of all cases of the disease. The only way to detect it is to carry out serological tests, when an increase in antibody levels can be detected.

Currently, there is an increase in the number of cases of the disease in adults, in whom rubella in its typical course has a number of features.

Symptoms of rubella in pregnant women:

The incubation period for the disease lasts 11 - 24 days. During this period, viruses that have entered the body multiply intensively in the cells of the mucous membranes of the upper respiratory tract and lymph nodes, which enlarge towards the end of the prodromal period (usually occipital). With rubella, the groups of occipital and posterior cervical lymph nodes most often enlarge. Their size reaches a large pea or more, they are of medium density, painful on palpation. As the rash disappears, the lymph nodes decrease in size.
Rubella in pregnant women is often severe, with high (up to 39 o C) body temperature, severe headache, severe muscle and joint pain, and lack of appetite.
Catarrhal phenomena of the upper respiratory tract and inflammation of the conjunctiva of the eyes are significantly expressed.
Rash in pregnant women tends to merge. When merging, extensive spots are formed.
The most common complication in pregnant women is polyarthritis.

Rice. 3. The photo shows rubella during pregnancy. A rash and enlarged lymph nodes are the main symptoms of rubella in pregnant women.

Rubella during pregnancy: consequences

In women who suffered from rubella while in the 3rd to 4th week of pregnancy, from 50 to 85% of cases of birth of children with congenital deformities are registered.
Long-term suppression of the immune system during illness leads to the development of sore throats, otitis media, bronchitis and pneumonia.
Sometimes arthritis or arthralgia are recorded. The joints of the fingers and wrist become inflamed more often. Sometimes the knee joints become inflamed. Arthritis and arthralgia last no more than a month after the rash appears.
Encephalitis and meningitis develop very rarely.

Of particular danger is the development of rubella in the fetus in the case of an involuntary (asymptomatic) form of the disease in a pregnant woman.

Rice. 4. The photo shows congenital rubella. Deafness is one of the common manifestations of SLE.

How does intrauterine infection of the fetus develop?

The rubella virus during pregnancy affects embryonic tissue in the early stages of pregnancy, when the active formation of organs and systems of the fetus occurs. Fetal growth slows down and normal organ formation is disrupted.

In 10 - 40% of cases, pregnancy ends in spontaneous abortion, in 20% - in stillbirth, in 10 - 25% - in the death of the newborn.

Viruses penetrate from mother to fetus during the period of viremia (release of viruses into the blood). This period begins a week before the rash appears and continues for some time after the rash appears. There is an assumption that rubella viruses first infect the epithelium covering the chorionic villi and capillaries of the placenta. They then enter the fetal circulatory system. The resulting chronic infection causes the development of congenital deformities.

Viruses inhibit the miotic activity of cells. Organ cell populations slow down in growth. They become incapable of differentiation, which prevents proper development organs.
The ability of rubella viruses to destroy cells manifests itself only in the cochlea of the inner ear and the lens of the eye, causing congenital deafness and cataracts.

Rice. 5. The outer part of the fetal membrane of the embryo is called the chorion (6th week of pregnancy in the photo).

Viruses cause maximum harm to the fetus when infected in the first trimester of pregnancy (first 12 weeks). At the 13th week and later, fetal development defects develop less frequently. The danger persists until the 3rd trimester.

Rice. 6. The photo shows the fetus (6th and 10th weeks of pregnancy).

Rubella in pregnant women: consequences for the child

In 1941, the Austrian researcher N. Gregg described anomalies in newborns whose mothers had rubella during pregnancy. Cataracts, deafness and heart defects are called “congenital rubella syndrome” (CRL). Subsequently, the list of these vices expanded significantly.

Congenital rubella syndrome: timing and frequency of development

Between 3 and 11 weeks of pregnancy, defects of the central nervous system develop. At 4–7 weeks of pregnancy, defects of the heart and visual organs develop. The incidence of malformations in the 3rd - 4th week of pregnancy is 60%.
Between 7 and 12 weeks, hearing defects develop. The incidence of malformations during this period is 15%.
The incidence of malformations at 13–16 weeks of pregnancy is 7%.

Rice. 7. Congenital rubella. Eye cataract.

Congenital rubella: list of fetal development defects

Congenital rubella syndrome today usually includes:

Malformations of the heart, which manifest themselves in the form of patent ductus arteriosus, ventricular septal defect, pulmonary stenosis.
Eye malformations manifest as corneal opacities, chorioretinitis, cataracts, microphthalmia, glaucoma and retinopathy.
Deafness is one of the most common congenital defects.
Malformations of the central nervous system manifest themselves in the form of defects in the formation of the skull and brain (microcephaly), accompanied by mental retardation.
Hypotrophy and intrauterine growth retardation.
Developmental defects internal organs: bone damage, enlarged liver and spleen, myocarditis, interstitial pneumonia, thrombocytopenic purpura, hemolytic anemia, dermatitis, etc.

TO late developmental defects include thyroiditis, diabetes and progressive subacute panencephalitis.

To more rare malformations include malformations of the skull, bone skeleton, genitourinary organs and digestive system.

Difficult to recognize during the newborn period, such defects as deafness, pathology of the heart and visual organs (congenital glaucoma, high degree of myopia).

Chronic meningoencephalitis is difficult to recognize in a newborn. Lethargy, drowsiness or increased excitability and convulsions are its main symptoms.

It is difficult to recognize thyroiditis and diabetes mellitus in a newborn.

Rice. 8. Deafness, cataracts and heart defects make up the classic congenital rubella syndrome.

Tests for rubella during pregnancy

Modern diagnostics of rubella allows you to quickly make the correct diagnosis and prescribe adequate treatment, which can significantly alleviate the patient’s condition and carry out timely preventive measures, preventing infection of others and contact persons. The causative agents of the disease (viruses) contain substances (antigens) that can cause an immune response in the body of an infected person (the formation of antibodies). Antibodies and antigens are detected and studied using serological reactions. They are based on the body's immune reactions.

Testing for rubella during pregnancy using a serological research method is fundamental in diagnosing the disease and in identifying the level of protective antibodies in the blood that appear after vaccination in the past.

Antibodies to rubella during pregnancy are detected using the neutralization reaction (RN), complement fixation (RSF), hemagglutination inhibition (HAI), latex agglutination, radial hemolysis reaction (RHR), immunoblotting technique and “trap” ELISA. All of the above methods are inexpensive, sensitive and reliable.

Rice. 9. Set of reagents “BioScreen-Rubella-IgG”, which is used for the quantitative determination of specific antibodies (immunoglobulins).

Antibodies to rubella during pregnancy

Antibodies formed as a result of vaccination or after previously suffering from rubella penetrate the placenta and mother's milk, protecting the fetus from infection and rubella during the first year of the unborn child’s life. If a pregnant woman unprotected from rubella comes into contact with a patient, a disease may develop in which viruses can penetrate the fetus and cause the development of many malformations. Antibodies to rubella during pregnancy are determined using serological tests.

If a woman planning a pregnancy does not remember whether or not she was previously vaccinated against rubella, it is necessary to do an immunological test for the presence of anti-rubella antibodies in the blood.

Tests for rubella in pregnant women and their interpretation

Analysis "Anti-Rubella-IgM positive during pregnancy" means that the pregnant woman has rubella. Antibodies - immunoglobulins of class M are produced in the body of a pregnant woman during illness within 1 - 3 days.
"Anti-Rubella-Ig In a patient with rubella, they appear 3 to 4 weeks after the disease or their titer increases. This analysis helps to retrospectively assess the situation. An increase in antibody titer by four times or more indicates the severity of the disease.

Tests for rubella when planning pregnancy and their interpretation

"Anti-Rubella-IgG positive during pregnancy" in a healthy woman means that anti-rubella antibodies are present in the blood. A positive test confirms a previous history of rubella or previous vaccination against the disease.
If the level of anti-Rubella-IgG is less than 10 U/ml, this means that the amount of antibodies in a person’s blood is insufficient to protect against the disease. When the concentration of anti-Rubella-IgG is more than 10 U/ml, we can talk about the presence of immunity to infection.
« AntiRubella-IgG negative during pregnancy" means the absence of IgG antibodies. In this case, vaccination is indicated 2 months before the planned pregnancy.

Rice. 10. Cataract is one of the most common congenital defects associated with rubella.

Measures to take when a pregnant woman comes into contact with a person with rubella

If a pregnant woman comes into contact with a patient, a serological blood test is performed to determine antibodies to Rubella virus.

Antibodies to rubella of the IgG class are always present in the blood of a person who has previously had the disease or has been vaccinated. They provide protection to the body from re-infection. The absence of antibodies means that the pregnant woman is not protected from the disease and there is a risk of infection if she comes into contact with a sick person.
In case of contact with a patient and in the absence of IgG antibodies in the blood of the pregnant woman, the test is repeated after 4 - 5 weeks. In case of a positive result ( « AntiRubella-IgG positive" during pregnancy) it is recommended to terminate the pregnancy. In case of a negative analysis, the test is repeated after 1 month. Negative test ( « AntiRubella-IgG negative" during pregnancy) indicates that upon contact with the patient, infection of the pregnant woman’s body did not occur and the pregnancy can be maintained.
If, after contact with a patient, 2-4 weeks later, IgM antibodies and low-avidity IgG are detected in the blood of a pregnant woman, this indicates that infection has occurred. If infected in the first trimester, the pregnancy must be terminated. If infected at 14-16 weeks of pregnancy, the issue of terminating or continuing the pregnancy is decided at a medical consultation.

The absence of symptoms of rubella in a pregnant woman after contact with a sick person does not exclude the absence of the disease. The asymptomatic form of rubella poses the same danger to the fetus as the manifest form.

Rice. 11. Malformations of the central nervous system in congenital rubella manifest themselves in the form of defects in the formation of the skull and brain (microcephaly), accompanied by mental retardation.

Treatment of rubella in pregnant women

When treating the disease, only symptomatic therapy methods are used, since specific (etiotropic) therapy for this infection is limited this moment not developed.

It is not recommended to administer immunoglobulin to prevent the disease during pregnancy. The administration of immunoglobulin is permitted if a woman, after contact with a person with rubella, insists on continuing the pregnancy. However, birth healthy child in this case it is not guaranteed.

Rubella vaccination and pregnancy

Vaccination against rubella before pregnancy is carried out 2 months before the planned pregnancy.

Rice. 12. The photo shows mono-vaccines.

Rubella vaccine before pregnancy

If there are no IgG antibodies in the blood, the woman is vaccinated two months before the planned pregnancy. In the Russian Federation, a monovaccine is used for these purposes. Rudivax(France), Rubella vaccines(India and Croatia).

Before pregnancy, the rubella vaccine is administered intramuscularly into the shoulder area in a volume of 0.5 ml.
Immunity after vaccination develops after 15-20 days and lasts for 15-25 years.

Rice. 13. Vaccination against rubella before pregnancy will prevent the birth of a sick child.

Vaccination against rubella during pregnancy

Despite the fact that accidental rubella vaccination during pregnancy does not have a negative effect on the fetus, pregnancy today is a contraindication for vaccination.

According to the latest data (more than 1000 pregnant women were studied), when pregnant women who denied pregnancy were vaccinated, infection of the fetus with vaccine viruses was quite often observed, but this did not in any way affect its development. Occasional rubella vaccination during pregnancy is not an indication for termination of pregnancy.

Rubella vaccine after pregnancy

If a pregnant woman is unvaccinated, she is vaccinated after childbirth, but only after an immunological examination. A woman is vaccinated in the absence of IgG antibodies in the blood after childbirth ( « AntiRubella-IgG negative").

Vaccination against rubella for pregnant women who have previously had the disease

When the rubella vaccine is administered to people who have previously had the disease, nothing bad will happen. Antibodies in the blood will block vaccine viruses.

Repeated vaccination (re-vaccination) before pregnancy

Repeated vaccination (re-vaccination) when vaccinated before pregnancy is not carried out.

Consequences of the rubella vaccine

Rubella vaccination before pregnancy: consequences

Reactions to rubella vaccination are rarely recorded.
It may manifest as local tenderness, fever, and enlarged occipital lymph nodes.
Transient acute arthritis and arthralgia appear 1 to 3 weeks after vaccination. More often the knee and wrist joints are involved in the process. The complication is registered in girls and young women.
Vaccine reactions such as anaphylactic reaction and thrombocytopenia have been reported rarely.
A reaction to a vaccine can develop as a result of errors that occur during immunization: administration of an increased dose of the vaccine, violation of the route of administration of the drug, violation of antiseptic rules.

Rubella vaccination during pregnancy: consequences

According to the latest data (more than 1000 pregnant women were studied), when vaccinating pregnant women who denied pregnancy, infection of the fetus was quite often observed, but this did not in any way affect its development.

Vaccination against rubella in the postpartum period: consequences

Reactions to vaccinations carried out in the postpartum period and 7 days after the start of the monthly cycle are extremely rare.

Rice. 14. In one month the baby will be born (in the photo the fetus is at the 36th week of pregnancy).

It is not at all dangerous to his health and proceeds without the slightest complications - this is very early childhood. In all other cases, this disease can lead to a number of serious complications. This disease is especially dangerous for pregnant women, or rather, for their unborn children. And first of all, this disease is incredibly dangerous in the first trimester of pregnancy, when the formation of absolutely all vital organs and their systems actually occurs.

What is this disease?

So, rubella is the same thing, and it is extremely easily transmitted by simple airborne droplets directly from person to person. Simply put, rubella can be spread by sneezing, coughing, and even talking. But to become infected, it will take quite a long period of time and quite close contact with an already sick person. So, for example, for infection it is enough, say, to care for a sick child, and simply staying indoors together during the day will give a negative result or other similar situations. The incubation period of this disease lasts from 15 to 21 days, and it can be really very difficult to determine the moment of infection, since during the first time this infection occurs with a latent character. Rubella virus is usually sensitive to exposure high temperatures and various chemicals.

Main symptoms and course of this disease

In young children, this disease almost always begins very acutely. This is how a peculiar pale pink and small-spotted rash appears directly on the skin, but does not rise above the surface of the skin at all. As a rule, the size of such spots never exceeds 3 or 5 mm. Moreover, at first the rash appears only on the face, and then quite quickly spreads throughout the body, especially many elements appear on the back, on the buttocks, on the inner surfaces of the arms, as well as the legs. However, this rash never appears directly on the palms of the hands. Later, there may even be some enlargement of the posterior cervical or occipital lymph nodes, and there may well be a slight increase in body temperature. In some cases, inflammation appears in the upper respiratory tract and, as a complication, inflammation of certain joints may occur.

It should be noted that in adults this disease is always much more severe and with greater complications. Before the appearance of reddish spots in a person, the general condition of the body may well deteriorate. And this can be manifested by general malaise, and headache, and chills with an increase in body temperature to 38° or more, and pain in the joints, and a runny nose, and of course, a sore throat. In addition, there is often a significant increase in lymph nodes, especially the posterior cervical and of course the occipital. Also, more than a third of all sick adults may experience some damage to the brain, as well as to small joints in the hands.

Patients with rubella become infectious to everyone around them already seven days before the initial appearance of the rash on their body and remain real sources of infection for approximately 7 or even 10 days after its main appearance.

Certain features of rubella virus infection during pregnancy

It must be admitted that during pregnancy, this virus, first of all, can infect the tissues of the embryo, and very easily and freely penetrates the baby through the placenta. And as you understand, in the first trimester this can lead to chronic infection of the fetus itself, which can disrupt its normal intrauterine development. The rubella virus can often cause miscarriage. Moreover, the shorter the pregnancy period at which infection could occur, the more often and more severely developmental defects in the fetus will develop. For example, infection of a pregnant woman in the first eight or even ten weeks of pregnancy, in almost 90% of all cases, can lead to the development of dangerous defects.

Among which:

Various malformations of the small heart.
Absolute or partial deafness.
A disease such as cataract.
Frequent disturbances in mental development.

In addition to this development of defects directly in the fetus, completely other types of complications during pregnancy may well occur: this is not pregnancy, and even stillbirth.

Now we hasten to inform you that, let’s say, a woman’s infection, which occurs after the twentieth week, will have virtually no negative or dangerous effect on both the development and health of the baby.

Treatment of rubella virus

It is worth saying that when suffering from rubella, as a rule, no strictly specific treatment is required. The sick woman is indicated for complete isolation and just bed rest. But in cases of complications, of course, analgesics or sulfonamide drugs can be prescribed. In addition, in some more complex cases, the doctor still prescribes antibiotics or gargling with some antiseptic solutions.

In addition, human gamma globulin can often be administered, which can actually alleviate the course of this disease. To tell the truth, these measures, as a rule, are not taken directly in relation to pregnant women, since all this cannot prevent damage to the fetus.

Indications for premature termination of pregnancy

Let us say right away that if infection of the embryo could still occur, the issue of urgent termination or continuation of this pregnancy is immediately brought up for consideration. So, for example, if this happened in the very early stages of pregnancy, when the likelihood of possible dangerous complications the unborn child has the maximum, the pregnant woman is still recommended to terminate this pregnancy. But at later stages, the pregnancy is usually still left, but if there are documented lesions in the fetus, an abrasion procedure may also be recommended. If such an infection occurs in the mother, say, during pregnancy later than 28 weeks, she is simply registered in a separate group of women at high risk, where she will be under almost constant medical supervision.

Monitoring of pregnant women with rubella virus

Let us immediately note that if for some reason a pregnant woman is not given an artificial termination of pregnancy, she is clearly classified as a special risk group and her pregnancy is monitored taking into account such a dangerous condition. In such cases, urgent treatment of this condition is carried out as well as placental insufficiency, in addition to this, special preventive measures and of course restorative therapy. This helps to easily avoid much worse consequences and simply prevent spontaneous miscarriage. It is also taken into account, among other things, that rubella that occurs during pregnancy can harm not only one fetus, but can also cause real complications directly in the mother’s body during childbirth. This, first of all, can manifest itself in disturbances of normal labor, blood poisoning and even severe bleeding.

In addition, a child with signs of congenital rubella can also pose a real danger of infection for all the people around him, and for several months immediately after birth.

The main signs of congenital rubella in a newborn

So, as we have previously noted, a child born from a previously infected mother may exhibit the following unpleasant disorders. Firstly, this is eye damage, as well as heart defects, complete or partial deafness, and dangerous brain damage (this includes encephalitis and even meningitis). And secondly, these may be malformations of the skeleton, organs such as the liver and spleen, and even the genitourinary organs. In addition, some infected children who do not have such symptoms are often born with too little body weight and also with short stature, and accordingly, in the future they constantly lag behind in their physical development.

What should a pregnant woman do if she finds herself in a rubella virus outbreak?

In the case where a pregnant woman has not previously had rubella, and also did not consider it necessary and did not even consider it possible to determine the existing immunity to this virus in her body, and at the same time found herself in contact with a previously infected person, then she will need to immediately contact an experienced infectious disease specialist. However, the most modern and common research methods can answer questions about the presence or absence of immunity in her body to rubella - this, of course, is the determination of antibodies of classes such as IgM and IgG.

Existing immunity to the rubella virus

As you've probably already heard, a person can only get rubella once in their life. And at the same time, a completely stable immunity to this virus is formed in his body for the rest of his life. Therefore, for women who have already been ill before (and their unborn children), this infection cannot pose the slightest danger. To tell the truth, one cannot be completely and completely sure that, say, the woman herself already has immunity to rubella, simply based only on the fact that she has already had this unpleasant disease at some point in early childhood. This can only be due to the fact that the general symptoms of her childhood illness could only be mistaken for rubella, but completely wrongly. And at the same time, a woman could well have suffered from some latent form of rubella, say, without the manifestation of its usual symptoms. And in order to verify the exact presence (or vice versa absence) of existing antibodies to this virus, it will be necessary to conduct a special laboratory examination.

Possibility of vaccination against rubella

If a woman does not have strong immunity to the rubella virus, she may be offered vaccination against this virus in order to avoid the risks of infection. Moreover, such a vaccination will need to be done at least in advance, namely three months before pregnancy occurs. And if in your house you have a sick person suffering from rubella, then, unfortunately, it is already very late and makes no sense to do such a vaccination.

Contraindications for standard rubella virus vaccination

In no case should such a vaccination be done during pregnancy, since this virus, even if weakened, can damage the fetus.

In addition, vaccination against the rubella virus cannot be given to those people who have certain disorders of the immune system. And in particular, these are: diseases such as leukemia, lymphoma, various malignant diseases, and, of course, congenital immunodeficiencies.

In addition, vaccination will also be contraindicated for those people who are currently taking any corticosteroid drugs, as well as for all those who are somehow exposed to chemotherapy or other radiation.

If a woman has previously had severe allergic reactions to taking, say, the antibiotic “neomycin,” then vaccination is also not considered possible. One more thing possible contraindication to vaccination is a sharp increase in body temperature, leading to figures of up to 38°C and above.

Rubella is a viral infection that is often called German measles, although it has nothing to do with measles. Anyone who is not vaccinated has a risk of becoming infected. In children, it is most often asymptomatic, but rubella during pregnancy is very dangerous for the woman herself and can have dire consequences for the child. But not everything is so scary, because if you are vaccinated, you have nothing to be afraid of.

What happens in the body of a woman who has become infected with the virus? In women, the disease is practically asymptomatic. The incubation period lasts 12 -23 days.

Since the rubella vaccine is live (weakened), after vaccination you should avoid planning your baby for at least 4 weeks. However, you will then know for sure that you have protected your unborn child from the terrible consequences of this infection.

And finally, I suggest you watch a video with Elena Malysheva, who explains why rubella is extremely dangerous during pregnancy:

If you have any questions, leave your comments at the end of the article. Be healthy.