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Congenital Rubella

Last updated Aug. 15, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Congenital Rubella is a type of in-utero infection, which occurs in a fetus, whose mother is infected with rubella virus.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Congenital Rubella Syndrome (CRS)
  • CRS (Congenital Rubella Syndrome)
  • Pediatric Rubella

What is Congenital Rubella? (Definition/Background Information)

  • Congenital Rubella is a type of in-utero infection, which occurs in a fetus, whose mother is infected with rubella virus. This infection occurs anytime during the first 3 months of pregnancy. The condition may cause some serious birth defects, and it may also be fatal to the fetus
  • The signs and symptoms depend upon the severity of the infection, which are wide-ranging, affecting many body parts and systems. They may include slow fetal growth, neurological abnormalities, bone and teeth problems, heart defects, eye and ear problems, etc.
  • A team of medical doctors and professionals may be required to arrive at a treatment plan, which is mostly symptomatic and based upon the health condition of the child and the set of abnormalities observed
  • Mild cases of Congenital Rubella Syndromes (CRS) have much better prognoses than severe infections. The prognosis depends on the severity of CRS and the complications that develop in the child
  • Congenital Rubella is a completely preventable disorder in newborn children, if the mothers are properly vaccinated against rubella virus, either during early pregnancy stages, or prior to pregnancy

Who gets Congenital Rubella? (Age and Sex Distribution)

  • Congenital Rubella Syndrome occurs in the developing fetus of a pregnant woman, during her first trimester
  • Both male and female babies are equally at risk
  • There is no predilection towards any particular race or ethnic group
  • However, in certain countries and geographical regions where rubella vaccination coverage is poor (such as SE Asia and Africa), the incident rate of CRS is much higher
  • In some of the developed nations of the world, such as US and Europe, Congenital Rubella has almost been eliminated

What are the Risk Factors for Congenital Rubella? (Predisposing Factors)

The risk factors for Congenital Rubella include:

  • Infection of the mother prior to or during pregnancy, particularly within the first 3 months of pregnancy
  • Lack of immunization against the rubella virus in the mother

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Congenital Rubella? (Etiology)

  • Rubella is a contagious and infectious disease caused by the rubella virus
  • It is an airborne disease. When an infected individual coughs or sneezes, the virus in the tiny respiratory droplets, get mixed in the air and spread
  • When a pregnant woman, who is in her first trimester (first 12 weeks of pregnancy) is exposed to or inhales this infected air, she contracts rubella. The woman may come in direct contact with an infected person‘s respiratory secretions, such as mucus. The infection is then transmitted to her fetus through blood, by the placenta

What are the Signs and Symptoms of Congenital Rubella?

The signs and symptoms of Congenital Rubella in the newborn baby depend on the severity of the infection and may include the following:

  • Slowing of fetal growth, small head circumference
  • Hearing loss (deafness)
  • Dental and bone problems
  • Vision problems, such as glaucoma, cataract, retinal inflammation, even blindness
  • Abnormally small eyes; abnormal smallness of the uvea (middle layer of the eye)
  • Heart defects
  • Enlargement of the liver and spleen, resulting in liver and spleen damage
  • Neurological abnormalities including developmental delays; mental retardation
  • Chronic meningitis (infection of the linings of the brain)
  • Excessive sleepiness, irritability, low birth weight
  • Convulsions (seizures)
  • Skin rashes at birth

How is Congenital Rubella Diagnosed?

A diagnosis of Congenital Rubella may involve:

  • Physical examination and medical history evaluation of the mother
  • Physical examination of the newborn child
  • Blood and urine test may be conducted to check for the presence of rubella virus in the infant
  • Peripheral blood smear examination
  • Liver function blood tests
  • Brain (neurological) and heart exam in the baby
  • Examination of the baby’s eyes (vision), ears (hearing)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Congenital Rubella?

Congenital Rubella can affect many parts of the body in the newborn and cause complications, such as:

Eyes:

  • Cataract
  • Glaucoma (increased pressure in eyes)
  • Retinitis (inflammation of retina)

Heart:

  • Patent ductus arteriosus (PDA): Heart defect that causes abnormal blood flow in heart
  • Pulmonary artery stenosis: Narrowing of the pulmonary artery, which carries blood to the lungs from the heart
  • Other heart defects

Central nervous system:

  • Mental retardation
  • Motor retardation (causing poor muscular movement)
  • Small head, because of failed brain development (called oligocephaly)
  • Encephalitis (inflammation of brain)
  • Meningitis (inflammation of the covering of the brain)

Other complications may include:

  • Deafness
  • Low blood platelet count (thrombocytopenia)
  • Enlarged liver and spleen (hepatomegaly and splenomegaly)
  • Abnormal muscle tone
  • Bone disease
  • Abortion and preterm babies; stillborn child

How is Congenital Rubella Treated?

  • The treatment for Congenital Rubella is based on the defects found in newborns and infants. It may include a combination of medications, surgeries, physical therapy, and other therapies
  • A detailed discussion with the healthcare provider is needed to determine the best treatment to be provided
  • A team of medical specialists are needed to treat severe cases of Congenital Rubella Syndrome
  • If the infant is suffering from heart or eye defects, early surgery may be performed to correct them

How can Congenital Rubella be Prevented?

Congenital Rubella can be prevented by adopting the following safety measures, namely:

  • All women, who have attained child-bearing age should be vaccinated against rubella. It is the best method available to prevent this infection from affecting the fetus
  • Immunity screening should be done as part of prenatal medical exam
  • Caretakers of the infants infected with rubella, should be vaccinated against rubella virus
  • If you are pregnant, stay away from individuals having infections, such as rubella; especially if you are in your early stages of pregnancy (the first 90 days)

What is the Prognosis of Congenital Rubella? (Outcomes/Resolutions)

  • The outcome of Congenital Rubella depends on the extent of the damage, suffered by the infant
  • Mild cases have a much better prognosis than severe Congenital Rubella cases. Defects affecting the heart and eye may be rectified; however, damage to the nervous system remains permanent

Additional and Relevant Useful Information for Congenital Rubella:

The following article link will help you understand rubella blood test:

http://www.dovemed.com/common-procedures/procedures-laboratory/rubella-blood-test/

The following article link will help you understand peripheral blood smear examination:

http://www.dovemed.com/common-procedures/procedures-laboratory/peripheral-blood-smear-examination/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 7, 2014
Last updated: Aug. 15, 2018