German measles pregnancy

Rubella and pregnancy | March of Dimes

Rubella is an infection that causes mild flu-like symptoms and a rash.

Vaccines usually given in childhood prevent you from getting the infection

Up to half of people infected with rubella don’t have any symptoms but still can spread it to others.

You can get rubella from an infected person who coughs or sneezes, or by sharing food or drinks with someone who is infected.

Rubella can cause serious problems for your baby if you get infected while pregnant, especially during the first three months of pregnancy.

Rubella, also called German measles, is an infection that causes mild flu-like symptoms and a rash. Up to half of people infected with rubella don’t have any symptoms and may not even know they’re infected but still spread it to other people.

If you get infected during pregnancy, rubella can cause serious problems for your baby. Infection causes the most severe damage when the pregnant person is infected early in their pregnancy, especially in the first 12 weeks (3 months).

Rubella has been nearly eliminated in the United States because of the routine vaccination of children. Vaccination protects a person against rubella for life. But people who were never vaccinated as children can get infected. You can be vaccinated as an adult when you are not pregnant.

Between 2005 and 2011, 67 cases of rubella were reported in this country. This is up from the previous period—2001 to 2004—when only 5 cases were reported. Vaccination is the best way to prevent infection. Today, less than 10 people in the United States are reported to have rubella and it is usually associated with travel and not being vaccinated.

Rubella is common in many other countries. Travelers can bring it into the United States, or you can get it when traveling outside the country.

It’s important to get vaccinated for rubella. Talk to your health care provider to make sure you’re protected against it. A blood test can provide you with information about your immunity to rubella

What are the signs and symptoms of rubella?

Rubella is usually mild, with flu-like symptoms followed by a pink or light red rash. The rash usually starts on the face, then spreads to the rest of the body. The rash lasts about 3 days. Other symptoms include:

Low-grade fever (102 F/38.9 C or lower)
Headache
Loss of appetite
Runny nose
Sore throat
Cough
Red eyes or pink eye (conjunctivitis)
Swollen glands in the neck or behind the ears
Muscle aches or joint pain

Up to 7 in 10 (70 percent) teenage and adult women who get rubella develop arthritis. Arthritis is swelling and pain in your joints. Women who are infected with rubella may feel arthritis in their fingers, wrists and knees. This complication is rare in men or children who get rubella. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems.

Some people have no symptoms so you may not know that you or they have rubella.

What causes rubella?

Rubella is caused by a virus (a tiny organism that can make you sick). It is not caused by the same virus that causes measles. It’s very contagious. It spreads through the air when an infected person coughs or sneezes, or by sharing food or drinks with someone who is infected. It also can be passed to a baby from a pregnant person who is infected.

A person with rubella may spread the disease to other people up to 1 week before they notice a rash. Infected people can continue to spread the disease up to 7 days after getting a rash.

People infected with rubella should tell their friends, family, and the people they work with if they have rubella. If your child has rubella, it’s important to tell their school or daycare provider. Telling others helps prevent the spread of rubella to even more people.

What problems can rubella cause during pregnancy?

Rubella can be serious for the baby, especially during the first 3 months. Having rubella during pregnancy increases the risk of:

Congenital rubella syndrome (CRS) – This is a condition that happens when a pregnant person passes rubella to their baby during pregnancy. It may cause your baby to be born with one or more birth defects, including heart problems, vision problems, deafness, intellectual disability, low birthweight, bone marrow problems, and liver and spleen damage. There is no cure for CRS. However, from 2005 to 2018, only 15 babies were diagnosed with CRS in the U.S., according to the Centers for Disease Control and Prevention (CDC).
Miscarriage – This is when a baby dies before 20 weeks of pregnancy.
Stillbirth – This is when a baby dies after 20 weeks of pregnancy.
Preterm – This is birth that happens before 37 weeks of pregnancy

Can you pass rubella to your baby during pregnancy?

Yes. The best way to protect your baby is to make sure you’re immune to rubella. Immune means being protected from an infection. If you’re immune to an infection, it means you can’t get the infection.

You are probably immune to rubella because you were vaccinated as a child or you had the illness during childhood. A blood test can tell if you’re immune to rubella. If you’re thinking about getting pregnant and aren’t sure if you’re immune, talk to your health care provider about getting a blood test. If you were not born in the United States or came as an adult you may not be vaccinated against rubella. Ask your health care provider to do a blood test to see if you are immune to rubella.

If you’re not immune to rubella, here’s what you can do to help protect your baby:

Before pregnancy. Get the measles, mumps and rubella (MMR) vaccine. Wait 1 month before trying to get pregnant after getting the shot.

During pregnancy. You can be tested at a prenatal visit to make sure you’re immune to rubella. If you’re not immune, the MMR vaccine isn’t recommended during pregnancy. But there are things you can do to help prevent getting infected with rubella:

Stay away from anyone who has the infection.
Tell your health care provider right away if you’ve been in contact with someone who is sick and may have rubella.

After pregnancy. Get the MMR vaccination after you give birth. It is safe to get the MMR vaccine while nursing. Being protected from the infection means you can’t pass it to your baby before they get their own MMR vaccination at about 12 months. It also prevents you from passing rubella to your baby during a future pregnancy.

What are the chances of passing rubella to your baby during pregnancy?

You’re more likely to pass rubella to your baby the earlier you become infected during pregnancy. For example:

If you get rubella in the first 12 weeks of pregnancy, your baby has an 8 to 9 in 10 chance (85 percent) of getting infected. This is a very high chance.
If you get rubella at 13 to 16 weeks of pregnancy, your baby has a 1 in 2 chance (50 percent) of being infected.
If you get rubella at the end of your second trimester or later, your baby has a 1 in 4 chance (25 percent) of getting infected.

If you have rubella during pregnancy, your baby’s provider will carefully monitor your baby after birth to find any problems early.

How is rubella treated?

There is no specific medicine to treat rubella. In many cases, the symptoms of the disease are mild. Staying in bed (bed rest), drinking fluids and taking medicines to reduce fever can help.

Pregnant people with rubella may be treated with acetaminophen to relieve their symptoms. In more serious cases, treatment may include blood transfusion or steroids. A blood transfusion is when you have new blood put into your body. Steroids are synthetic hormones that treat inflammation.

Contact your health care provider if you are pregnant and think you have rubella or have been exposed to the disease.

Last reviewed: August 2021

See also: Your baby’s vaccinations, Vaccinations and pregnancy

Rubella (German measles) in pregnancy

What is rubella?

Rubella, commonly known as German measles, is an infection that affects the skin and lymph nodes. It is caused by a virus. Rubella is serious in pregnant women because of the effect it can have on an unborn child.

What are the symptoms of rubella?

When children get rubella, it is usually a mild illness. Sometimes they have no symptoms at all, but they can still spread the infection to others.

Symptoms may include:

A low-grade fever and mild aches and pains, sometimes red eyes.
A rash of pink or light red spots that start on the face and spread down to the rest of the body.
Neck glands may swell up and feel tender, especially behind the ears.

The sickness lasts about 3 days and generally gets better on its own without any complications. In teens and adults, rubella can be a more serious disease. Joint pain is common.

How is rubella spread?

The rubella virus passes from person to person through droplets from the nose or throat of someone with rubella. These droplets may land in the nose or mouth of someone who is close by, especially when the infected person coughs or sneezes.

Rubella is most contagious a few days before and after the rash appears.

What about pregnant women and rubella?

Rubella in pregnancy is now very rare in Canada because most women have been vaccinated against it.

If a pregnant woman gets rubella during the first 20 weeks of pregnancy, she usually passes the disease on to her unborn baby. The baby will have congenital rubella. Babies with congenital rubella are contagious for more than a year.
If the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many life-long problems. The most common are eye problems, hearing problems and damage to the heart.
If the fetus gets rubella between 12 and 20 weeks of pregnancy, problems are usually milder.
There are rarely problems if the fetus gets rubella after 20 weeks of pregnancy.

There is no treatment for rubella infection.

What can you do to prevent rubella while you are pregnant?

If you've had the rubella infection or have been vaccinated, you are likely protected.

If you aren’t sure if you had a rubella vaccine, you should have a blood test before you get pregnant. The test will tell you if you are protected against rubella.
If a blood test shows you are not protected against rubella, you should get the MMR vaccine right away. The vaccine should be given at least 4 weeks before you become pregnant. You cannot get this vaccine when you are pregnant.
If you are already pregnant and do not know if you are protected against rubella, ask your doctor to test you. If you are not, avoid close contact with people who have rubella, and those who have had a rash for less than a week unless a doctor has told them that the rash is something other than rubella.
If you are not immune, you should be vaccinated as soon as possible after your baby is born, before leaving the hospital.

More information from the CPS

Reviewed by the following CPS committees

Infectious Diseases and Immunization Committee

Last updated: October 2021

Virus dangerous to the fetus (rubella and its prevention)

Rubella is an acute viral disease characterized by a small-spotted rash, generalized lymphadenopathy, moderate fever and fetal damage in pregnant women.

The source of infection is a person with rubella. Of great epidemiological importance are patients without a rash, as well as children with congenital rubella, in whose body the rubella virus can persist for many months (up to 1.5 years or more). The disease occurs in the form of epidemic outbreaks, which are repeated after 7-12 years. Sporadic cases are observed during the inter-epidemic period. The maximum number of diseases is registered in April-June. During outbreaks, not only children, but also adults get sick. The rubella virus is released into the external environment a week before the rash appears and within a week after the rash. Infection occurs by airborne droplets.

Rubella is especially dangerous for pregnant women due to intrauterine infection of the fetus. The frequency of fetal lesions depends on the timing of pregnancy. Rubella disease at 3-4 weeks of pregnancy causes congenital malformations in 60% of cases, at 9-12 weeks - in 15% and at 13-16 weeks - in 7%.

In pregnant women with rubella, the virus circulates in the blood, enters the placenta, multiplies there and infects the fetus. The infection causes chromosomal changes, which leads to a lag in physical and mental development. Congenital rubella leads to a significant delay in the development of the child (height and body weight). In most patients, the liver and spleen are enlarged, congenital heart defects are detected. Approximately half of the patients develop eye lesions (microphthalmos, cataracts, glaucoma), deafness often develops. Sometimes congenital deafness is the only malformation due to rubella. The bones of the limbs and skull may be affected, anemia or thrombocytopenia with hemorrhagic diathesis and other malformations develop.

With congenital rubella, the pathogen persists for a long time (up to 18 months) in the child's body. The child during all this time can be a source of infection for other children.

In order to prevent rubella, the National Immunization Schedule provides for vaccination of children aged 12 months. and revaccinations at the age of 6 years.

By order of the Ministry of Health and Social Development of the Russian Federation of January 31, 2011 No. 51 n “On approval of the national calendar of preventive vaccinations and the calendar of professional vaccinations for epidemic indications”, immunization of all children from 1 to 18 years old who were not ill, not vaccinated or vaccinated once was also introduced against rubella, as well as girls from 18 to 25 years old who have not been vaccinated and have not had rubella.

Before vaccinating women, special attention should be paid to the date of the last menstrual period (exclude pregnancy) and contraceptive counseling to avoid vaccinating women during pregnancy and planning a pregnancy after it.

Doctor - epidemiologist of the GBUZ RK "KRPC" V.V. Danshchikova

90,000 rubella during pregnancy - the hospital "LELECA"

What is rubella?

Rubella - an infectious disease that is accompanied by high fever and skin rashes, as well as chills, redness of the face, sore throat and lymph nodes. Rubella is classified as a childhood disease: this highly contagious virus most often affects children of preschool and primary school age. The infection is transmitted only from person to person by airborne droplets, the peak incidence occurs in the spring. Sometimes adults get sick too. Subject to the regimen, the disease is easily tolerated and does not cause complications.

Rubella during pregnancy

Rubella is considered a dangerous disease during pregnancy. In the first trimester, the transferred rubella increases the risk of miscarriage up to 40%, fading of pregnancy and the birth of a dead child - by 20%, the death of a baby in the first year of life - 10% higher. The virus inhibits the process of cell division. During the period of intensive development of the fetus, laying and formation of internal organs, the action of the virus can critically affect the viability of the fetus, as well as the ability of its organs to fully perform their functions.

The most dangerous period is up to the 14th week of pregnancy, when all the main organs are laid in the fetus. If a pregnant woman becomes ill, the virus can pass through the placenta to the fetus and cause congenital rubella syndrome. This syndrome causes pathologies of development: from 3 to 11 weeks of pregnancy - the brain, 4-7 weeks - pathologies of the eyes and heart, 7-13 - hearing impairment; during the same period, rubella can lead to the appearance of a cleft lip, as well as other pathologies and deformities in the fetus, up to its complete non-viability. Most often, the "Gregg triad" develops (cataract - 75% of cases, heart disease - 50%, deafness - 50%). Unfortunately, after suffering rubella, auto-abortion often occurs, or premature birth, in which the fetus is born unviable.

Congenital rubella syndrome

From about 16 weeks, the risk of dangerous pathologies due to congenital rubella syndrome decreases, the consequences of the disease are not so critical. But if a pregnant woman has been ill with rubella before 14 weeks, this is the official reason for artificial termination of pregnancy. A woman should remember that the decision to terminate a pregnancy is not made by the doctor, but by herself. In such a situation, the doctor can only advise and advise. If a woman hesitates in making a decision, a consultation with a gynecologist can help her.

A special fetal blood test will help determine if the rubella virus has been able to cross the placenta and pose risks to the fetus. In addition, it is recommended to prescribe an additional ultrasound diagnostic session in order to examine the development of the baby's vital organs and exclude the development of pathologies.

Another danger of rubella is that it can be asymptomatic in adults. Thus, a woman can get rubella without noticing it. If cases of rubella are recorded in the region, pregnant women are offered to undergo a special analysis for antibodies. The presence in the blood of a pregnant woman of a large number of antibodies to the causative agent of this disease will show whether the woman was sick.

Vaccination against rubella

Rubella is included in the list of diseases against which babies in Ukraine are vaccinated at the age of one year. The incidence of rubella is low. If for some reason a pregnant woman has not been vaccinated against rubella, she should inform her doctor at the time of registration for pregnancy. However, even childhood vaccination does not provide 100% protection against the disease. Ideally, the rubella vaccine should be done additionally, a few months before the planned pregnancy. This is especially true for women who work in areas with an increased risk of disease - children's educational institutions, children's clinics, etc. If you are planning a pregnancy and there are cases of rubella in your area, you should consider additional vaccination. Studies show that women who have been vaccinated shortly before pregnancy do not develop fetal abnormalities caused by the rubella virus.