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4: Y4 - Obstetrics [13] > [29] Rubella Infection in Pregnancy > Flashcards

[29] Rubella Infection in Pregnancy Flashcards

1
Q

What is rubella?

A

A single stranded RNA virus

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2
Q

What has happened to the incidence of rubella in the UK?

A

It has reduced dramatically

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3
Q

Why has the incidence of rubella in the UK reduced dramatically?

A

Because of the introduction of the MMR vaccination programme

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4
Q

What is the result of the dramatic reduction in the incidence of rubella in the UK?

A

The antenatal screening programme that used to be performed was stopped in 2016

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5
Q

Why is rubella in pregnancy still an important issue in healthcare?

A

It is still a big problem worldwide

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6
Q

How is the rubella virus transmitted?

A

Via the respiratory route

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7
Q

Where does the rubella virus replicate?

A

Nasopharynx and lymph nodes

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8
Q

What happens to the rubella virus after it replicates in the body?

A

It is found in the blood 5-7 days after the infection, and spreads throughout the body

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9
Q

Why is rubella infection a problem in pregnancy?

A

It has teratogenic properties, and is capable of crossing the placenta and infecting the fetus

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10
Q

What are the risk factors for rubella infection in pregnancy?

A
  • Incomplete immunisation
  • Exposure to infectious contact
  • International travel
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11
Q

What is the most common presentation of maternal rubella?

A

Often asymptomatic

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12
Q

What the symptoms of maternal rubella, if present?

A

Non-specific, and include;

  • Malaise
  • Headache
  • Coryza
  • Lymphadenopathy

This can be followed by a diffuse fine maculopapular rash

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13
Q

What investigation is done when maternal rubella infection is suspected?

A

ELISA

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14
Q

What is the purpose of ELISA in maternal rubella infection?

A

Can measure rubella specific IgG and IgM

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15
Q

What is found on ELISA in acute rubella infection?

A

IgM antibody

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16
Q

What is found on ELISA following rubella infection or vaccination?

A

IgG antibody

17
Q

How is maternal rubella managed?

A

Rubella infection itself is self-limiting, and so there is no treatment, but anti-pyretics can be given for fever

18
Q

What should a woman with rubella be informed of regarding her infectivity?

A

She is infective from 7 days prior to the onset of symptoms to 4 days after

19
Q

What determines the risk of vertical transmission of rubella and the likelihood of developing congenital rubella syndrome?

A

Gestational age at the time of infection

20
Q

What is the risk of vertical transmission of rubella if <12 weeks gestation?

A

90%

21
Q

What is the risk of congenital rubella syndrome if <12 weeks gestation?

A

90%

22
Q

Are single or multiple defects likely with rubella infection <12 weeks gestation?

A

High likelihood of multiple defects

23
Q

What is the risk of vertical transmission of rubella if 12-16 weeks gestation?

A

55%

24
Q

What is the likelihood of congenital rubella syndrome if 12-16 weeks gestation?

A

20%

25
Q

Are single or multiple defects likely with rubella infection 12-16 weeks gestation?

A

Single

26
Q

What is the risk of vertical transmission of rubella if 16-20 weeks gestation?

A

45%

27
Q

What is the likelihood of deafness if contract rubella at 16-20 weeks gestation?

A

20%

28
Q

What is the risk of vertical transmission of rubella if >20 weeks?

A

45%

29
Q

What is the risk of developing congenital rubella syndrome if >20 weeks gestation?

A

None?

30
Q

What is the recommended management for rubella infection <12 weeks gestation?

A

Termination

31
Q

What is required when there is rubella infection at 12-20 weeks?

A

Prenatal diagnosis of rubella infection

32
Q

How is a prenatal diagnosis of rubella infection made?

A

RT-PCR on amniotic fluid samples

33
Q

What are the management options if a prenatal diagnosis of rubella infection is made at 12-20 weeks?

A
  • Termination of pregnancy

- Ultrasound surveillance to identify features of congenital rubella syndrome

34
Q

What is the management of rubella infection at >20 weeks gestation?

A

No action required

4: Y4 - Obstetrics [13] (61 decks)

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