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
- Infection in first trimester has 80% chance of defects
- 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
- Deafness, 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
