Among the group of TORCH infections, which, when developed in a woman during pregnancy, can cause congenital pathologies in the fetus, one of the most dangerous is rubella. The rubella virus is transmitted to a pregnant woman often from children who fell ill during epidemics in schools and kindergartens. An infection that occurs in the first months of pregnancy provokes the development of fetal pathologies such as cataracts, deafness, and heart defects. That is why the primary infection that occurs in the first 16 weeks of pregnancy is an indication for its termination. It is important for doctors to have information about how rubella is diagnosed during pregnancy, and what prevention methods will help prevent the disease.
What methods will help prevent the development of rubella during pregnancy
The rubella virus that enters the body of a pregnant woman has the ability to cross the placenta into the body of the fetus, causing serious malformations in it. The incubation period of the infection is quite long - 16-18 weeks, which means that the risk of infection with a previously unaffected rubella and unvaccinated pregnant woman is quite high, subject to contact with a person with rubella. However, not always a single or short-term contact is capable of provoking infection, which is why the diagnosis of rubella during pregnancy is performed in both the mother and the fetus.
Rubella during pregnancy:
- methods for diagnosing rubella during pregnancy in the mother;
- methods for diagnosing rubella during pregnancy in the fetus;
- rubella prevention: when and who should be vaccinated.
Methods for diagnosing rubella during pregnancy in the mother
Laboratory testing for rubella during pregnancy should be done in women who have been in contact with people with rubella or who have an illness that is characteristic of rubella. The main laboratory method for diagnosing rubella is the detection of specific antibodies to the rubella virus in the blood of a pregnant woman. Screening of antibodies and determination of the increase in their titers is performed using the following methods:
- radial hemolysis (HR);
- enzymatic immunoassay (ELISA);
- latex agglutination (LA);
- haemagglutination inhibition test (HAI).
Serological diagnosis of rubella during pregnancy is carried out by detecting a rise in lgG antibody titers by more than 4 times, as well as by detecting specific lgM antibodies to rubella virus.
Methods for diagnosing rubella during pregnancy in the fetus
Diagnosis of rubella during pregnancy is important not only for the mother, but also for the unborn child. Prenatal diagnosis, that is, intrauterine detection of a pathological process, is useful in cases where maternal infection occurs after the first trimester, or if there are doubts about the reliability of the diagnosis of a pregnant woman. Since abortion is not possible in the later stages, it is important to confirm the diagnosis of the fetus and determine what defects it has formed. The presence of rubella in amniotic fluid or fetal blood can be confirmed by detecting IgM antibodies to rubella virus using sensitive diagnostic tests such as PCR. Sonography makes it possible to detect heart defects: ventricular septal defect, components of Fallot's tetrad.
Rubella Prevention: When and Who Should Be Vaccinated
Prevention of the occurrence of rubella during pregnancy consists in carrying out a set of measures even before it occurs. All women of reproductive age should have serological tests to detect rubella antibodies in their blood. If antibodies are not detected, the woman should be vaccinated with a preliminary pregnancy test, since vaccination is contraindicated during pregnancy. A live attenuated vaccine is used, which is also contraindicated in people with severe immunosuppression. It is also important to vaccinate all children in a pregnant woman's family to prevent the rubella virus from entering the home.
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