Definition of Rubella – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Definition of Rubella
Definition of rubella:
Rubella is an acute, contagious viral infection. While the illness is generally mild in children, it has serious consequences in pregnant women causing fetal death or congenital defects known as congenital rabella syndrome (CRS). (WHO)
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A contagious viral disease, with symptoms like mild measles. It can cause fetal malformation if contracted in early pregnancy. The rubella virus is transmitted by airborne droplets when infected people sneeze or cough. Humans are the only known host.
Intrauterine transmission during different stages of pregnancy:
a) Stage 1: Preconception (minimum risk).
b) Stage 2: 0-12 weeks 100% risk of fetus being congenitally infected resulting in major congenital abnormalities. Spontaneous abortion occurs in 20% of cases.
c) Stage 3: 13-16 weeks Has risk of deafness and retinopathy 15% of the fetus.
d) Stage 4: After 16 weeks Normal development, slight risk of deafness and retinopathy.
Risk factors of Rubella during pregnancy:
➤ Being unvaccinated.
➤ Traveling internationally.
➤ Having a vitamin A deficiency.
➤ Not vaccinated or haven’t complete vaccination course properly against Rubella.
➤ Haven’t complete blood group test before getting pregnant because most of the time
Rubella is asymptomatic before manifested its symptoms.
Causes of Rubella during pregnancy:
➤ Close contact through the air.
➤ Droplet neuclei (such as sneezing and coughing).
➤ Contaminated materials.
➤ Pregnant women to fetus through blood stream.
➤ Inhaling droplets from infected person.
➤ Poorly functioning organs.
Sign and symptoms of Rubella during pregnancy:
➤ Pink or red rash that begins on the face and then spreads downward to the rest of the body
➤ Mild fever, usually under 1021.
➤ Swollen and tender lymph nodes
➤ Runny or stuffy nose
➤ Muscle pain.
➤ Inflamed or red eyes
➤ Prolonged headache.
➤ Earache
➤ Stiff neck
➤ headache
➤ Inflamed or red eyes.
la rare cases,
➤ prolonged headache
➤ earache
➤ stiff neck
Diagnosis Rubella in pregnancy:
➤ By the appearance of rashes face and lower part of the body skin.
➤ By some blood test (TC, DC, ESR, Hb%, CBC, Blood culture and others test of binods).
➤ Antibody test of immune system to detect currently the virus develops or not.
Nursing interventions/management of Rubella in pregnancy:
➤ lsaolute patients for 5-7 days after rash onset.
➤ Identify and vaccinate susceptible persons who have no contraindications to rubella vaccine.
➤ Ensure that pregnant women who are exposed to rubella and do not have adequate proof of immunity are serologically evaluated to see Laboratory Diagnosis of Rubella,
➤ Pregnant women may be treated with antibodies called hyper-immune globulin that can fight off the virus. This can help reduce patient symptoms.
➤Counsel susceptible pregnant women regarding the risks for intrauterine rubella infection and recommend that they restrict their contact with persom for fi weeks after rash onset,
➤ Pregnant women should also be advised to avoid activities where they might be exposed to rubella for 6 weeks after the onset of symptoms of rubella.
➤ Acetaminophen for symptomatic relief according to the advice of the physician.
➤ Immunized both mother and infant both against Rubella, Mumps and Meanies. The vaccine should be live and attenuated and confers lifelong immanity.
Complication of Rubella during pregnancy:
➤ Premature labor.
➤ Spomanoous abortion
➤ Low birth weight.
➤ Intrauterine death.
➤ Congenital malformation of major argan systems.
➤ Congenital rubella.
➤ High fever (105F-106F),
➤ Birth defect.
Consequences of Rubella during pregnancy on fetus and mother:
➤ miscarriages
➤ stillbirths
➤ delayed growth
➤ intellectual disabilities
➤ heart defects
➤ deafness
➤ Poorly functioning organs.
Prevention of Rubella in pregnancy:
➤ Rubella vaccine: RA 27/3 strain, 0.5ml, lifelong immunity in 95%.
➤ Clinical Investigation for immunization: during pregnancy.
➤ Recipients of vaccine should be advised not to become pregnant in 3 months after getting vaccine.
➤ MMR vaccine
➤ Immunized both mother and infant both against Rubella, Mumps and Measles.
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