Congenital rubella: Difference between revisions

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* Spectrum of disease, which includes [[Causes::intra-uterine fetal demise]], [[Causes::preterm delivery]], and the congenital rubella syndrome
* Spectrum of disease, which includes [[Causes::intra-uterine fetal demise]], [[Causes::preterm delivery]], and the congenital rubella syndrome
* Severity depends in part on timing of infection
* Severity depends in part on timing of infection
** Infection in first trimester has 80% chance of defects
** Up to 8 weeks gestation: 20% chance of spontaneous abortion
** Up to 10 weeks: 90% chance of congenital rubella syndrome (severe defects)
** 13-18 weeks: 10-20% chance of hearing loss and retinopathy
** Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
** Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
** [[Causes::Intra-uterine growth restriction]] is likely only effect in third trimester
** [[Causes::Intra-uterine growth restriction]] is likely only effect in third trimester
* Most children are asymptomatic at birth, but can develop signs and symptoms after several years
* Most children are asymptomatic at birth, but can develop signs and symptoms after several years

* [[Causes::Deafness]], [[Causes::cataracts]], [[Causes::glaucoma]], [[Causes::congenital heart disease]], and [[Causes::cognitive defects]]
=== Congenital rubella syndrome ===
* [[Causes::Sensorineural hearing loss]] (most common findings), blueberry muffin rash (from extramedullary hematopoiesis), [[Causes::cataracts]], [[Causes::glaucoma]], [[Causes::congenital heart disease]], and [[Causes::cognitive defects]]
* [[Causes::Low birth weight]], [[Causes::thrombocytopenic purpura]], [[Causes::hepatosplenomegaly]], [[Causes::meningoencephalitis]], [[Causes::retinopathy]], [[Causes::patent ductus arteriosus]], [[Causes::pulmonary stenosis]], developmental disorders, [[Causes::cryptorchidism]], inguinal hernia
* [[Causes::Low birth weight]], [[Causes::thrombocytopenic purpura]], [[Causes::hepatosplenomegaly]], [[Causes::meningoencephalitis]], [[Causes::retinopathy]], [[Causes::patent ductus arteriosus]], [[Causes::pulmonary stenosis]], developmental disorders, [[Causes::cryptorchidism]], inguinal hernia
* By the second decade of life, it can cause a progressing, fatal [[Causes::panencephalitis]]
* By the second decade of life, it can cause a progressing, fatal [[Causes::panencephalitis]]

Revision as of 21:23, 9 February 2020

Background

Pathophysiology

  • Transplacental transfer of rubella virus occurs during viremia, which peaks about 5 to 7 days following infection of mother
    • Mother may be asymptomatic

Clinical Presentation

  • Spectrum of disease, which includes intra-uterine fetal demise, preterm delivery, and the congenital rubella syndrome
  • Severity depends in part on timing of infection
    • Up to 8 weeks gestation: 20% chance of spontaneous abortion
    • Up to 10 weeks: 90% chance of congenital rubella syndrome (severe defects)
    • 13-18 weeks: 10-20% chance of hearing loss and retinopathy
    • Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
    • Intra-uterine growth restriction is likely only effect in third trimester
  • Most children are asymptomatic at birth, but can develop signs and symptoms after several years

Congenital rubella syndrome