German Measles in Pregnancy

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German Measles in Pregnancy

  1. 1. German Measles in Pregnancy Dr. Margarita Isabel Amoroso-Artes Department of OB/GYN Davao Medical Center
  2. 2. Your Topic Goes Here <ul><li>Minor importance in absence of pregnancy </li></ul><ul><li>During pregnancy: </li></ul><ul><ul><li>Directly responsible for abortion & severe congenital malformations </li></ul></ul>
  3. 3. Congenital Rubella Syndrome
  4. 4. TERATOGENIC <ul><li>12 weeks AOG- 80% </li></ul><ul><li>13-14 weeks- 54% </li></ul><ul><li>End of 2 nd trimester- 25% </li></ul>
  5. 5. <ul><li>Eye defects- cataract & glaucoma </li></ul><ul><li>Heart disease- PDA & Peripheral pulmonary artery stenosis </li></ul><ul><li>Sensorineural deafness- most common single defect </li></ul><ul><li>CNS- microcehaly, developmental delay, MR, meningoencephalitis </li></ul><ul><li>Purpura </li></ul><ul><li>Hepatosplenomegaly & jaundice </li></ul><ul><li>Radiolucent bone disease </li></ul>
  6. 6. <ul><li>Neonates with the disease </li></ul><ul><ul><li>Continue to she the virus for months </li></ul></ul><ul><ul><li>Threat to other infants as well as to adults </li></ul></ul>
  7. 7. Diagnosis <ul><li>Mild febrile illness </li></ul><ul><li>Generalized maculopapular rash </li></ul><ul><li>Arthralgias/arthritis </li></ul><ul><li>Lymphadenopathy </li></ul><ul><ul><li>Suboccipital </li></ul></ul><ul><ul><li>Postauricular </li></ul></ul><ul><ul><li>cervical </li></ul></ul><ul><li>conjunctivitis </li></ul>
  8. 8. <ul><li>Incubation period- 12 t0 23 days </li></ul><ul><li>20-50% asymptomatic </li></ul><ul><li>Viremia precedes clinical signs by a week </li></ul><ul><li>Adults are infectious during viremia through 5-7 days of rash </li></ul>
  9. 9. <ul><li>Clinical </li></ul><ul><li>ELISA- specific IgM antibody </li></ul><ul><ul><li>4-5 days after onset </li></ul></ul><ul><ul><li>Persist 8 weks after rash appearance </li></ul></ul><ul><li>ELISA- IgG antibody </li></ul><ul><ul><li>Peaks 1-2 weeks after rash onset </li></ul></ul><ul><ul><li>If specimen obtained 10 days after rash: failure to differentiate very recent disease & preexisting immunity </li></ul></ul>
  10. 10. Prevention
  11. 11. <ul><li>25% in the US susceptible (large epidemics have disappeared) </li></ul><ul><li>Congenital Rubella still common in developing countries </li></ul>
  12. 12. Goal: ERADICATION <ul><li>Immunization of the adult population </li></ul><ul><li>MMR- offered to women of childbearing age </li></ul><ul><li>Vaccination </li></ul><ul><ul><li>Part of general routine medical checkup </li></ul></ul><ul><ul><li>In family planning settings </li></ul></ul><ul><ul><li>Provided routinely to unimmunized women after hospitalization, childbith or abortion </li></ul></ul>
  13. 13. End
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