Rubella is a common childhood illness. What can it threaten during pregnancy? Statistics amazes with scary figures. Congenital rubella syndrome in newborn infants occurs annually. Up to 300,000 babies are born with this diagnosis. In the Russian Federation, 1/6 of all children with visual defects are malformations obtained under the influence of rubella on pregnancy. The consequences of this disease are terrible. And the saddest thing is that the standard symptoms in a sick person may not be observed at all. Children rubella (Rubella virus) tolerate from the age of 3 to 9 years. The disease is characterized by a small rash throughout the body and inflammation of the lymph nodes in the neck (often closer to the back of the head).
Rubella in pregnant women
The complications that a girl may encounter if there is no immunity from rubella during pregnancy are determined by the following factors:
- The virus, infecting the blood cells of a woman, sneaks into the placenta. Thus, the fetus is under serious threat, the likelihood of malformations is high.
- The sixth part of miscarriages in the first trimester and the birth of dead babies occurs due to this disease in a woman.
- Even after birth, the rubella virus lives in the baby’s body for two years. Accordingly, it can infect someone around. The risk remains if the baby has antibodies in the blood.
Danger
The results and consequences of rubella in pregnant women are unpredictable. The virus spreads by airborne droplets from an infected person. Subsequently, the sick mother passes the rubella to the baby in the womb.
Through the air, the virus spreads instantly in a team. To prevent this disease, it is necessary to refrain from prolonged contact with the carrier. Chickenpox and measles, for example, are transmitted much faster.
Penetrating through the placenta into the baby’s blood, the virus destroys cells that are just starting to form. Genetic material spoils. If the pregnant woman is at the 3rd or 4th week, in almost 90% of cases, a baby with appearance defects is born. If a baby was born with this disease, it will transmit the virus through secretions and mucous membranes. Mom herself transfers the virus further, even before the onset of the external manifestations of the disease.
Symptoms
The form of the disease exists in three types: standard, atypical (there are no rashes on the body) and asymptomatic. Moreover, rubella most often occurs without symptoms (90% of cases). It can only be detected by passing appropriate analyzes.
What are the symptoms of rubella during pregnancy in women? These include:
- The period of manifestation of the disease (incubation) is from 11 to 24 days. Viral cells settle in the upper respiratory tract and begin to multiply actively. The lymph nodes on the head fall under the blow, usually closer to the back of the head. They swell and become the size of an average pea. They can be felt through the skin, when pressed, pain is felt. The longer the disease lasts, the smaller the lymph nodes become.
- The severe course of the disease is accompanied by a high temperature (from 39 degrees). A woman has a body aches and a headache, the need for food disappears.
- The vessels of the eyeballs swell, there is a slight swelling of the eyelids.
- Small red rash on the body. It has the ability to "unite" and form large spots.
- As a consequence, joint inflammation and joint pain are often expressed.
According to the first signs, a woman might think that she has the usual SARS. But even in this case, it is important to remember that those drugs that you usually take during pregnancy are not recommended. Carefully read the instructions for the drugs, from which "Biseptolum", "Co-trimoxazole" and other drugs. Pay attention to contraindications.
Consequences for mother
The transferred rubella during pregnancy in the first trimester leads to defects in the appearance of the fetus. According to statistics, such consequences come in 50-85% of cases. Infants manifest external deformities, problems with the eyes or auditory function. For a pregnant woman, rubella is dangerous because with a long undermining of immunity, diseases of the upper respiratory tract and lung diseases (otitis media, bronchitis, pneumonia, etc.) develop. After a rash appears, arthritis or arthlargia may appear within a month. The upper limbs suffer, sometimes the knees. A rare consequence of rubella during pregnancy is meningitis or encephalitis.
Fetal infection
In the early stages of pregnancy, when all the systems of the baby’s body are laid, rubella affects the cells of the growing embryo in the most destructive way. Cell division slows down, the development of organs, the formation of the basic vital systems of the fetus stops. In the early stages of pregnancy with rubella, the consequences in the form of spontaneous miscarriage account for up to 40% of cases. 1/5 of the babies are born dead. Up to 25% are cases of early death of children. The acute period of exposure to the embryo passes until the 12th week of pregnancy, later the risk of developing defects in the child becomes lower, but the risk persists until the end of the third trimester.
With the passage of viruses in the mother's body into the blood, they gradually penetrate the uterine epidermis. The process of infection of the embryo begins about a week before the rash appears on the skin of a pregnant woman. Virus-infected cells attack the placental epithelium, and then move into the vascular system of the embryo. Rubella infection during pregnancy for the fetus is manifested by dysfunction of the vital systems and congenital external defects of the infant. This happens because the virus slows down the growth of embryo cells, this interferes with the full development of the future human body. In relation to vital systems, the virus manifests itself only in the formation of hearing and vision. Rubella during pregnancy often results in deafness or cataract in an infant.
Implications for the Baby
Congenital rubella syndrome (CRS) was first described in 1941. Austrian scientist N. Gregg recorded anomalies in children whose mothers suffered rubella during gestation. Over time, the list of rubella effects during pregnancy has expanded.
On what terms is the development of anomalies recorded:
- From the 3rd to the 11th week of pregnancy, the nervous system of the embryo suffers. From the 4th to the 7th week, the fetal heart and eyesight come under attack. More than half of fetal defects develop from the 3rd to 4th week of pregnancy.
- From the 7th to the 12th week, the auditory system suffers. The likelihood of a congenital disease here already falls and makes up 15% of the number of cases.
- From the 13th to the 16th week, the probability of developmental defects falls even lower and amounts to 7%.
What defects are related to ICS:
- Defects in the heart muscle (non-closure of the ductus arteriosus, ventricular septal defect, pulmonary stenosis).
- Visual defects (cataract, glaucoma, retinopathy, corneal opacity, chorioretinitis).
- Lack of hearing ability.
- Defects in the development of the nervous system are characterized by an improperly formed skull. The brain suffers, microcephaly develops. The consequence of rubella in pregnant women is the mental inferiority of the born child.
- Hypotrophy is a delayed fetal development.
- Defects in the development of the organs of the child. Enlarged liver and spleen, dermatitis, infection of bones, myocarditis, etc.
- Subsequently, when the child grows up, the manifestation of diabetes mellitus, inflammation of the thyroid gland tissue, and panencephalitis are likely.
- Rarely, defects in the bones of the cranium occur. Sometimes the skeleton, the organs of the genitourinary system and the digestive tract suffer.
How to learn about the disease?
Medicine has achieved excellent results in this matter. You can recognize the disease at any stage of its development. This will solve the problem with the spread of rubella among others, to take measures to alleviate the condition of the patient. The serosological test method is considered the most effective rubella test in pregnancy. Diagnosis is based on anamnesis and analysis of blood cells for antibodies.
How do antibodies work?
When a girl during the first weeks of pregnancy or planning cannot remember whether she was given a rubella vaccine, a blood sample is taken to check for the presence of antibodies. A fetal blood test is also performed. If those in the body of the expectant mother are found, then they penetrate the baby through the placenta and protect him from infection. Antibodies enter a body through a breast milk. Up to a year, a child needs protection from this disease to prevent malformations.
Contact between pregnant and infected
What to do if during pregnancy a woman encounters sick rubella? The first step is to take a blood test to detect antibodies. If a woman has previously been vaccinated or suffered a disease, then the tests will detect the presence in the blood of protection against reinfection. If no such antibodies are detected, the analysis is repeated after a month. If the result is positive (rubella is detected in the pregnant woman), it is recommended to terminate the pregnancy.
If the analysis is still negative, then a repeat of the blood sampling will take place another month later. And if the presence of rubella in a pregnant woman is not confirmed, then the child can be saved. If the infection occurred later, at the 14th week or more, then the issue of abortion is decided at the consultation.
How to treat?
The treatment of the disease is to eliminate its symptoms. It is necessary to lower the temperature, relieve rashes. Drug treatment of the focus of the disease by specialists has not yet been developed. Immunoglobulin (a substance containing antibodies) is not recommended to be introduced into the blood. It is possible only if the woman decided to leave the child. In standard treatment, bed rest, a lot of fluids, heat-reducing medications, and vitamins are recommended. It is important to know that taking antibiotics and anti-infective agents (including Analgin, Biseptol) is contraindicated during pregnancy.
Graft
To minimize the risk of rubella during pregnancy, vaccination is recommended two months before conception. Thus, antibodies will be formed in the body that protect the fetus, and the mother, in case of infection, will tolerate rubella much more easily. For this, the Rudivax vaccine is used.
Monovaccine is injected into the brachial muscle, its volume is 0.5 ml. Protective antibodies appear in the body after two to three weeks and persist for up to 25 years. During pregnancy, vaccination is prohibited. According to the results of studies in women who do not know about pregnancy and have been vaccinated, infection of the fetus was recorded. But no consequences were found on its development. After an accidental injection of rubella, pregnancy can be saved. After birth, vaccination can be done after examination. Re-vaccination against rubella before pregnancy is not carried out.
The consequences of vaccination
If vaccinated before pregnancy, then the following consequences for a woman are possible:
- There is usually no reaction to vaccination.
- If a reaction manifests itself, then in the form of a general malaise, a slight increase in temperature, an increase in lymph nodes on the back of the neck.
- In women of young age, manifestations of arthritis are recorded. Symptoms are observed one week after vaccination or a little later.
The remaining consequences are associated with improper administration of the drug (overdose, violations of antiseptic rules, etc.).
How to prevent the disease? Doctors Recommendations
Complex vaccination against rubella, measles and mumps is carried out at a young age. The first vaccination is given in 1 year, reactivation is carried out in 6 years. Girls and women can be re-vaccinated during pregnancy planning to avoid infection after conception. If vaccination has not been given, precautionary measures are recommended. In the event of a disease or symptom in the environment, you must immediately isolate yourself. Communication with an infected person must be stopped for at least 10 days.
It is recommended that a pregnant woman limit her stay in public places, especially in crowded areas. Many mothers with an older child are worried about what to do if they have rubella. A pregnant woman will have to leave the baby for a while, since there is a high risk of infection. The minimum period for which communication should be interrupted is 5 days. Caring for the child at this time will have to pass on to someone from loved ones.
It is important to remember that in a child, rubella is also treated by eliminating the external signs of the disease (antipyretics, bed rest, etc.). The use of such drugs as Bactrin, Biseptol is contraindicated. What these medicines help with is not associated with the manifestations of rubella in a child.
Finally
The network does not cease controversy over the feasibility of vaccination. The question is raised both in the context of childhood vaccinations and adults. Regarding rubella, the answer is obvious. To limit the risk of severe disease transmission in adulthood, especially for girls, doctors recommend instilling rubella. In the case of a categorical refusal of vaccination, parents can help ensure that the child suffers the disease at preschool age.
To do this, you can keep in touch with sick friends, for example. Thus, the child will become infected with rubella and be ill with it in childhood. Antibodies to the disease will form in his blood, which will give immunity for the next two decades. In this case, the girls will minimize the risks of rubella during pregnancy in the future, and the consequences for the fetus will not be critical.