Congenital rubella: Difference between revisions
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==Background== |
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* Risk of transmission is 90% for mother's infected in the first trimester |
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[[Category:Pediatrics]] |
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===Pathophysiology=== |
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*Transplacental transfer of [[rubella virus]] occurs during viremia, which peaks about 5 to 7 days following infection of mother |
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**Mother may be asymptomatic |
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*Spectrum of disease, which includes [[Causes::intra-uterine fetal demise]], [[Causes::preterm delivery]], and the congenital rubella syndrome |
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*Severity depends in part on timing of infection |
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**Up to 8 weeks gestation: 20% chance of spontaneous abortion |
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**Up to 10 weeks: 90% chance of congenital rubella syndrome (severe defects) |
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**13-18 weeks: 10-20% chance of hearing loss and retinopathy |
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**Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation |
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**[[Causes::Intra-uterine growth restriction]] is likely only effect in third trimester |
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*Most children are asymptomatic at birth, but can develop signs and symptoms after several years |
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===Congenital Rubella Syndrome=== |
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*By the second decade of life, it can cause a progressing, fatal [[Causes::panencephalitis]] |
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Latest revision as of 23:24, 21 September 2020
Background
- Risk of transmission is 90% for mother's infected in the first trimester
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 Manifestations
- 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
- Sensorineural hearing loss (most common findings), blueberry muffin rash (from extramedullary hematopoiesis), cataracts, glaucoma, congenital heart disease, and cognitive defects
- Low birth weight, thrombocytopenic purpura, hepatosplenomegaly, meningoencephalitis, retinopathy, patent ductus arteriosus, pulmonary stenosis, developmental disorders, cryptorchidism, inguinal hernia
- By the second decade of life, it can cause a progressing, fatal panencephalitis
