1/11. An epidemic of congenital rubella in barbados.Rubella and congenital rubella syndrome (CRS) are preventable, but epidemics of rubella and CRS are not infrequent in the Caribbean and other developing countries. As a result of a surveillance system initiated after an epidemic of rubella in the Barbadian population in 1996, cases of CRS were identified and investigated. A total of seven cases of CRS were proven to be rubella IgM-positive. The infants were found to have a mean birthweight of 2587 g and a mean gestational age of 38 weeks. The clinical course, complications and outcome of those infants were documented and the cost of acute hospital care for each patient was also recorded. Cataracts in four infants, congenital heart disease in three and central nervous system abnormalities in five were the major clinical abnormalities. In four infants, two or more clinical systems were affected. The combined total hospital stay was 105 days (mean 15, range 0-44). A national effort to immunize all those at risk and a strict surveillance programme are essential to prevent future epidemics. This would lead to a significant reduction in the number of cases of rubella and CRS and could effect substantial savings in the national health budget.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/11. prenatal diagnosis of congenital rubella infection in the second trimester of pregnancy.OBJECTIVES: This case report describes the clinical presentation, diagnosis and management of a case of acute rubella infection in the second trimester. The complex issues of prenatal diagnosis of a congenital rubella infection are discussed. methods: A 30-year-old woman presented with a fine macular rash at 15 weeks' gestation. Laboratory testing included maternal rubella-specific IgG and IgM detection (booking blood and acute-phase sample) together with measurement of IgG avidity. prenatal diagnosis at 19 weeks (amniocentesis) and 23 weeks (amniocentesis and fetal blood) was done using a reverse-transcriptase polymerase chain reaction to detect rubella-specific rna. The fetal blood sample was also tested for rubella-specific IgM. RESULTS: Maternal serological results confirmed an acute rubella infection at 15 weeks' gestation. Rubella-specific rna and IgM were detected in the fetal blood taken at 23 weeks' gestation. However, no rubella rna was detected in either of the amniotic fluid samples collected at 19 and 23 weeks. CONCLUSION: In second-trimester rubella where risk of fetal damage is low, prenatal diagnosis can identify the rubella-infected fetus, allowing the parents to make a more informed decision about their options. The optimal sample for prenatal diagnosis is fetal blood as no rubella-specific rna was detected in the amniotic fluid.- - - - - - - - - - ranking = 4.6655849917518keywords = gestation, pregnancy (Clic here for more details about this article) |
3/11. Congenital rubella syndrome due to infection after maternal antibody conversion with vaccine.We experienced a case of congenital rubella syndrome (CRS) due to infection after maternal antibody conversion with vaccine. The mother was immunized with rubella vaccine at 14 years of age, and was confirmed as having rubella-specific hemagglutination inhibition (HI) antibody at the 1:16 level both at ages 26 and 30 during preceding pregnancies. At the second week of the third gestation, her second child developed rubella. She did not suffer any symptoms, but was found to have rubella HI antibody at the 1:512 level at 9 weeks of gestation. She delivered a male baby weighing 2,545 g at 38 weeks of gestation. He had congenital pneumonia, patent ductus arteriosus, bilateral cataracts, sensorineural deafness, and periventricular calcification of the brain. The rubella-specific antibody was 1:512 by HI and 10.1 by IgM enzyme-linked immunosorbent assay. According to these observations, he was diagnosed as having CRS. The rubella virus genome was detected in the fluids of the vitreous body using RT-nested PCR. This case emphasizes the importance of double-dose immunization (once in infants and once in young adults) in order to obtain an adequate level of antibody with duration sufficient to ensure the prevention of CRS.- - - - - - - - - - ranking = 3keywords = gestation (Clic here for more details about this article) |
4/11. A preventable case of congenital rubella syndrome and its public health implications.A failure to provide rubella immunization prior to conception, followed by failure to diagnose typical rubella during the first trimester of pregnancy, resulted in a case of congenital rubella syndrome. The ensuing malpractice suit was settled out of court 11 years later. Several reasons for the failure of prevention and diagnosis are discussed, along with the implications of the case for rubella prevention today.- - - - - - - - - - ranking = 0.41639624793796keywords = pregnancy (Clic here for more details about this article) |
5/11. Symptomatic rubella re-infection in early pregnancy and subsequent delivery of an infected but minimally involved infant. A case report.A case of serologically proven symptomatic rubella re-infection in early pregnancy in a healthy multigravida who had been successfully vaccinated is reported to illustrate that the risk to the fetus is considerably less than with primary infection. The infant was infected, as evidenced by specific IgM in cord blood, but had no stigmata of congenital rubella at birth. growth retardation was apparent at 6 months and hearing loss, not necessarily due to rubella, was detected at 8 months. Rubella re-infection, which may now be distinguished serologically by the urea degradation test from primary rubella, need not necessarily be an indication for termination of pregnancy.- - - - - - - - - - ranking = 2.4983774876277keywords = pregnancy (Clic here for more details about this article) |
6/11. Rubella-specific IgM in reinfection and risk to the fetus.A case of reinfection with the wild rubella virus in the 8th gestational week is reported. The patient had preexisting hemagglutination inhibition antibodies of low titer following immunization with rubella vaccine. Reinfection was accompanied by clinical symptoms and the presence of rubella-specific immunoglobulin m (IgM) of high titer. Following termination of pregnancy no rubella virus could be isolated from the fetal tissues and the fetal blood contained no specific IgM antibodies. These results should encourage the use of cordocentesis before decision on interruption of pregnancy.- - - - - - - - - - ranking = 1.8327924958759keywords = gestation, pregnancy (Clic here for more details about this article) |
7/11. Congenital rubella after previous maternal immunity.Two mothers who had asymptomatic rubella infection in pregnancy gave birth to severely affected infants. In both, the presence of preexisting antibody was well documented, although it could not be established whether it was the result of vaccine or natural infection.- - - - - - - - - - ranking = 0.41639624793796keywords = pregnancy (Clic here for more details about this article) |
8/11. Congenital rubella infection after previous immunity of the mother.A newborn boy was admitted with a congenital rubella infection. Seven years previously his mother had been vaccinated against rubella; 3 years previously rubella immunity had been confirmed. Therefore, intrauterine transmission must have occurred after maternal reinfection during pregnancy. prenatal diagnosis of rubella embryopathy with serological methods after subclinical maternal reinfection is nearly impossible.- - - - - - - - - - ranking = 0.41639624793796keywords = pregnancy (Clic here for more details about this article) |
9/11. Congenital rubella syndrome despite repeated vaccination of the mother: a coincidence of vaccine failure with failure to vaccinate.Congenital rubella syndrome occurred in a boy born to a mother who had been properly vaccinated three times before conception, but developed only low titers of rubella antibody. The non-vaccinated father most likely infected the mother on a home visit during the third to fifth weeks of gestation. He served in the army and fell ill during an outbreak of a rubella-like disease in his military unit. The mother subsequently developed a slight rash, but rubella IgM antibodies were lacking and rubella infection was not suspected. This incidence demonstrates the necessity of vaccinating all children, including boys and young men, in order to reduce the number of infections and prevent further cases of congenital rubella syndrome.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
10/11. Congenital rubella syndrome with rubella virus-associated generalized brownish macules, indurated erythemas, papules, and pigmentation.BACKGROUND: We examined an infant with congenital rubella syndrome (CRS). The purpose of this report is to describe the skin manifestations in this patient and to prove that they were associated with rubella virus. OBSERVATIONS: A 7-month-old boy presented with generalized brownish macules, indurated erythemas, papules, and pigmentation. They first appeared at around 3 months of age. His mother had contracted rubella during the 14th gestational week. At the time of examination, rubella-specific IgM antibody was positive in both serum and cerebrospinal fluid of the baby. A physical exam had revealed deafness, mental and physical retardation, interstitial pneumonitis, and hepatosplenomegaly. A skin biopsy specimen showed a dense infiltration mainly of lymphocytes, with B cells predominant in the deep dermis. Electron microscopically abundant tubuloreticular structures were observed in capillary endothelial cells, lymphocytes, and dermal fibroblasts. polymerase chain reaction (PCR) analysis suggested that rubella virus rna was present in the patient's skin specimen, cerebrospinal fluid, and total blood. CONCLUSIONS: The cutaneous manifestations of our patient were extraordinary and informative. These prominent skin lesions should be recognized as cutaneous markers of CRS.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
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