Rubella and pregnancy: what should a general practitioner do?

Abstract

Along with toxoplasmosis, cytomegalovirus, and herpes, rubella belongs to TORCH infections, i.e. the diseases that can have a detrimental effect on the fetus if infected during pregnancy. The disease is caused by a virus, the only known source and carrier of which is a person. The disease affects mainly children and young people, who tolerate the disease quite easily. As for the clinical symptoms, the appearance of a rash, a slight increase in temperature, regional lymphadenitis, and sometimes conjunctivitis should be noted. In adults, inflammation of the joints, the duration of which is usually 3-7 days, can also be noted. The rubella virus poses the greatest danger during the primary infection of a woman during pregnancy, especially in the first trimester. The probability of intrauterine infection of the fetus in this situation is 90%, resulting in its death or the development of congenital rubella syndrome (CRS). As a result, children with congenital rubella syndrome may suffer from developmental disorders, hearing and vision disorders, diabetes mellitus, and thyroid pathology. To prevent intrauterine infection of the fetus, vaccination against rubella is carried out, leading to the development of stable immunity. To date, rubella vaccination is carried out in 168 countries of the world, which makes it possible to cover about 70% of women with immunization. The countries of the African continent and South-East Asia are the least covered by rubella vaccination, resulting in about 4 cases of birth of children infected with the virus in utero per 1,000 bir ths.