Congenital rubella

Definition

Congenital rubella is a group of physical abnormalities that occur in an infant as a result of infection of the mother with rubella virus.

Causes, incidence, and risk factors

Congenital rubella is caused by the destructive action of the rubella virus on the fetus at a critical time in development. The most critical time is the first trimester (the first 3 months of a pregnancy). After the 4th month, maternal rubella infection is less likely to harm the developing fetus.

The incidence of rubella syndrome has decreased dramatically since the advent of rubella vaccine.

Risk factors include lack of the recommended rubella immunization and contact with a person who has rubella. Non-immunized, non-immune pregnant women are at risk for infection and subsequent damage to the fetus.

Symptoms

• History of mother having rubella while pregnant (particularly in the first trimester)
  
• Skin rash at birth (purpura, petechiae)
  
• Low birth weight
  
• Small head size (microcephaly)
  
• Lethargy
  
• Irritability
  
• Deafness
  
• Seizures
  
• Cloudy corneas or white appearance to pupil (leukocoria)
  
• Developmental delay
  
• Mental retardation
  

Signs and tests

Eye findings:

• Cataracts
  
• Glaucoma
  
• Retinitis
  

Congenital heart disease findings:

• Patent ductus arteriosus (PDA)
  
• Pulmonary artery stenosis
  
• Other heart defects
  

Central nervous system findings:

• Mental retardation
  
• Motor retardation
  
• Small head (microcephaly) from failed brain development
  
• Encephalitis
  
• Meningitis
  

Others associated findings:

• Deafness
  
• Low blood platelet count