• Congenital Rubella Syndrome

    (CRS)

    Definition

    Rubella is an infection caused by a virus. If a pregnant women becomes infected she can pass the infection to the unborn baby. This infection can lead to severe birth defects, miscarriage or stillbirth. The health problems due to the infection are called congenital rubella syndrome.
    Rubella Rash
    Rubella
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    Causes

    Congenital rubella syndrome is caused by an infection of the rubella virus. The virus first infects the mother. It then passes to the baby during pregnancy. The virus interrupts the development of the baby.

    Risk Factors

    There is a vaccination for rubella. If the mother has not had this vaccination, the baby has an increased risk of infection.
    The infection is most dangerous to the baby in the first trimester of pregnancy.
    Pregnancy in First Trimester
    9th week fetus
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    Symptoms

    Symptoms can vary depending on the timing of the infection. Some problems caused by congenital rubella include:
    • Slowing of fetal growth
    • Small head circumference
    • Hearing loss
    • Inflammation of the retina
    • Dental problems and other bone problems
    • Glaucoma
    • Cataract
    • Abnormal smallness of one or both eyes
    • Inflammation of the uvea (middle layer of the eye)
    • Heart defects
    • Enlargement of liver and spleen, including liver damage
    • Neurological abnormalities including developmental delay
    • Chronic meningitis

    Diagnosis

    Your doctor will ask about your child's symptoms and medical history. A physical exam will be done. Other tests may include:
    • Blood tests—to look for infection with rubella virus
    • Imaging tests—to look for problems in the brain

    Treatment

    Treatment will depend on the results of the infection. Certain eye and heart defects may be treated with surgery shortly after birth. Early intervention programs may also help babies with hearing loss, vision loss, or intellectual disability. Talk with your doctor about the best treatment plans for your child.

    Prevention

    Rubella vaccination for the mother can prevent congenital rubella syndrome. Screening for immunity may be done at premarital, preconception, or prenatal medical exams.
    Infants with congenital rubella can spread the infection. Anyone taking care of your infant should be vaccinated against rubella.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    March of Dimes http://www.marchofdimes.com

    CANADIAN RESOURCES

    Canadian Paediatric Society http://www.cps.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Congenital rubella syndrome. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=116060 . Accessed June 24, 2007.

    Kleigman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 18th ed. Saunders; Philadelphia, PA; 2007.

    Rubella. Center for the Evaluation of Risks to Human Reproduction website. Available at: http://cerhr.niehs.nih.gov/common/rubella.html#How%20Are%20Babies . Accessed July 12, 2007.

    Zimmerman L, Reef S. Chapter 12: congenital rubella syndrome. VPD Surveillance Manual . 3rd ed. 2002. Available at: http://www.cdc.gov/vaccines/pubs/surv-manual/downloads/chpt12%5Frub%5Fcrs.pdf . Accessed June 24. 2007.

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