Pregnant women with Rubella infection are at risk of conception

Pregnant women infected with Rubella in the first three months, 50% of births are teratogenic. Doctor Nguyen Ngoc Vinh, Head of Internal Medicine Department, Hospital for Tropical Diseases recommends that pregnant women consult a doctor if Rubella is infected in the first three months of pregnancy.

He said statistics worldwide, for pregnant women infected with rubella in the first three months, 50% of babies are born teratogenic. In the next three months, this rate decreased by more than 30%.

Infants infected with congenital rubella syndrome often exhibit: deafness, blindness, mental retardation and movement, cataract, retinopathy, congenital pneumonia, hepatosplenomegaly, congenital heart disease and bone damage . (Photo: VNN)

According to BS. Vinh, the first three months are three months of pregnancy development. This is the stage of fetal shaping, from eyes - lips - ears to limbs. The virus that causes Rubella will hinder one of those shaping processes.

Chronic infection with Rubella can infect embryos in an acute episode. Rubella virus can inhibit the ability to divide cells, or destroy cells (causing organ damage, eye injury in newborns .), or may damage the fetal blood vessels. and inner cochlea, heart, brain.

Mother carries the disease, she must bear the consequences

On February 12, 2001, the baby girl named NTL was born with a weight of 1,700 grams and was diagnosed by the doctors as follows: congenital abnormalities with small heads, small eyes, cataracts. In addition, after conducting a number of tests, it was discovered that the baby was connected, and the ductus arteriosus, had brain damage due to fetal infection. Six months later, baby D was discovered deaf on both sides.

Four months after the birth of the baby, surgery is performed on heart arteries. For the next 2 months, the baby went to the operating table for the second time due to a retinal disease.

By July 13, 2004, baby D was severely malnourished, unable to go on his own with a weight of 9.8kg, a height of 90cm, the first round was 46cm. The eyes are close to 14, 5 degrees, with glasses. Binaural hearing loss level 4 (wearing hearing aids). Children are not able to speak and listen very well.

The predecessor of mother D, TTPA, 23 years old, is very healthy but has not been vaccinated against Rubella. However, after 5 weeks of pregnancy, she had a moderate fever (38 - 38.5 degrees C), rash of face, limbs and spread all over her body.

After going for antenatal care on July 5, 2000, the doctor examined the amniotic fluid and discovered the uterus in the womb by 6 weeks of age. Re-examination on February 2, 2001 when the fetus was 37.5 weeks, fetus was underdeveloped, amniotomy, ventricular malformations and pericardial effusion.

"Abortion" if mother gets Rubella

Labor is one of four typical cases of congenital rubella syndrome in young children originating from the fetus.

Associate Prof. Dr. Le Diem Huong: Pregnant women often get infected very early (in the first three months of pregnancy) so children are at risk of congenital rubella infection syndrome (Photo: H.Cat) These typical cases Prof. Dr. Le Diem Huong, specialist of Pediatrics - Newborn, reported in "Vietnam - France Asia - Pacific Veneration Conference" in Ho Chi Minh City on 10 - 11/5/1005. Currently she is working at the International Maternity Hospital in Ho Chi Minh City.

In the report, Assoc. Prof. Dr. Le Diem Huong and her colleagues commented that most of these mothers have not been vaccinated before birth, symptoms of systemic rash occur before the 12th week of pregnancy. All babies are first-born children.

Mothers of very young age from 23 to 25 years old, mother's history of no miscarriage or stillbirth. Before becoming pregnant, these women do not show clinical signs of rubella infection, but often become infected very early in the first three months of pregnancy, so the risk of babies after birth is CRS very large. . Mother and baby tests show that the index of Rubella virus infection is very high.

Clinical manifestations of pregnant women are very clear: typhus, soreness, lymphadenopathy in 1 - 2 months, but they are not tested for IgM to prove the specific time of infection. When presented before the 5th obstetric and gynecological conference, Associate Prof. Dr. Le Diem Huong also confirmed with these cases, the possibility of primary infection is easy to occur in older children who are not immune to Rubella.

At that time, the women were regularly checked for pregnancy, the clinical characteristics of infection were recorded by the doctor, but little advice was given before the pathology of the baby after birth.

For newborns, the virus in the mother's blood passes through the placenta into the fetus, which occurs when the mother is sick for about 1 week before the rash starts and lasts 3-4 days after the rash.

In order to test for mother's infection, the virus can isolate the virus in the nasopharynx, urine, conjunctiva. Infants infected with Rubella find the virus up to 80-90%. In dying children, the virus can be found in the heart, brain, kidneys, lungs, liver, spleen, and thyroid gland.

Rubella (German measles) is the third factor, in the group that is prone to cause fetal infections. Rubella virus infection (Rubella) during pregnancy, especially in the first trimester or the last month of pregnancy can cause miscarriage, premature birth, stillbirth, malformations .

Although from the fetus, the fetus has been exposed to Rubella antigens, the less effective immune response newborns. Therefore, the most serious consequence for babies after birth is congenital rubella syndrome (CRS).

Children will be deaf, blind, mental retardation and movement, cataract, retinopathy, congenital pneumonia, hepatosplenomegaly, congenital heart and bone damage . at a rate of 0, twelfth%.

Meanwhile, according to Associate Prof. Dr. Huong, the cost of treatment for cases of illness is very expensive but ineffective. Therefore, pregnant women who have rubella infection in the first 3 months of pregnancy are "terminated".

Screening and immunization

Pregnant women should be consulted by a doctor when they get Rubella in the first trimester of their pregnancy to see if they should save them. (Artwork) By screening and immunizing at-risk populations, especially women of child-bearing age in countries, has been shown to be effective in preventing Rubella infection and CRS.

Rubella vaccine - mumps - Rubella is effective in immunizing against rubella and reducing CRS.

Vaccination room of Pasteur Institute in Ho Chi Minh City as well as all preventive medicine teams of districts have vaccines - vaccination. Includes: PRIORIX, TRIMOVAX, and MMR II, with prices from 110,000 to 120,000 VND / nose.

For children, children must be vaccinated with 2 MMR II shots; nasal injection (1) at 12-15 months of age and nose (2) at 4 - 6 years old.

Women in childbearing age must be given at least one injection. Women during pregnancy cannot get the vaccine. These pregnant women will be vaccinated after birth to be protected for the next pregnancy.

Scientifically, BS. Nguyen Ngoc Vinh said that in the current season in Ho Chi Minh City, vaccination is delayed.

Rubella is a disease that usually occurs in the winter or spring, and spreads very quickly through the respiratory tract. The disease is spread through coughing, sneezing when in contact with an infected person.

" In fact, 10 days before the rash, the patient was able to spread the disease and even 2 weeks after the rash was still able to spread the disease to others. Therefore, at that time, there was a sense of injection. prevention is no longer effective, "said the doctor. Vinh explained.

Therefore, when planning to become pregnant, the mother must be vaccinated against Rubella 3 months earlier.