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Other viral infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The congenital rubella syndrome (CRS) symptoms in decreasing frequency are hearing loss, mental retardation, cardiac malformations, and ocular defects (56,57). The greatest risk to the fetus is when maternal infection occurs in the first trimester. Congenital anomalies of the heart, eye, and CNS have been seen only if maternal infection occurred between 3 and 12 weeks. Deafness is the most common anomaly occurring in 58% of affected offspring and in 40% as a single defect (56). Patent ductus arteriosus was the most common cardiac defect and accounted for 79% of the cardiac anomalies seen (56,57).
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
The ‘congenital rubella syndrome’ was studied in great detail by Dr Lou Cooper (1968) from St Luke’s Roosevelt Hospital, Central New York, who conducted a long term follow-up of 20 000 children born with the syndrome in the USA during the rubella epidemic of 1964–1965. One-third of the patients were found to be profoundly handicapped and required institutional care. The typical syndrome comprised cataract, deaf mutism, congenital heart lesions, microcephaly, mental defects, pyloric stenosis and intestinal atresia. The risk of congenital defect after maternal rubella in the first trimester of pregnancy was 15–20%, being highest in the first month (about 50%) and lowest in the third month (about 8%). The infants born to mothers who had been infected during the second and third months of pregnancy had multiple handicaps and the majority of affected infants had degrees of deafness. Congenital defects were comparatively rare when rubella infection was contracted after the fourth month of pregnancy.
Rubella
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Progressive rubella panencephalitis (PRP) is a slow virus infection of the central nervous system. PRP was first reported in 1974 [38], and approximately 20 cases have been reported since then. All patients were male who were between the ages of 8 and 21 years at onset, and most had signs of congenital rubella syndrome [39], although some have occurred following acquired rubella. Although PRP may exhibit clinical features resembling SSPE, the age at onset is much older and the clinical course is more benign extending over several years with periods of stabilization and remission [40]. Some patients may develop myoclonus but this is not as prominent as seen with SSPE. The main neurological features of PRP are dementia, cerebellar ataxia, and seizures. CSF may be acellular or have a mild pleocytosis, with elevation of protein. It is characterized by high levels of immunoglobulins, oligoclonal bands and high CSF:serum rubella antibody titer ratios suggesting intrathecal synthesis of rubella specific antibodies [41]. Diffuse atrophy of the brain particularly the cerebellum with ventricular dilatation and high signal intensity lesion in white matter may be found on MRI. EEG recordings often show slowing although high voltage burst suppression and epileptiform abnormalities, have been described [42]. The prominent pathological findings in the brain included diffuse destruction of white matter with perivascular inflammatory cells and gliosis, moderate neuronal loss, numerous amorphous vascular deposits in the white matter and severe generalized cerebellar atrophy [43].
Pox Parties for Grannies? Chickenpox, Exogenous Boosting, and Harmful Injustices
Published in The American Journal of Bioethics, 2020
Heidi Malm, Mark Christopher Navin
We grant that physicians may sometimes have good reasons to treat patients in ways that avoid or reduce the risks of third-party harms. As we mentioned earlier, one reason to vaccinate children against rubella is to protect fetuses, for whom congenital rubella syndrome is very serious (Wilkinson et al. 2016). However, this permissible kind of other-regarding motivation in pediatric care does not sanction an EBH-informed refusal to recommend varicella vaccine. A pediatrician ethically may recommend the rubella vaccine because this vaccine also promotes a vaccinated child’s interests, as we discuss above. The fact that fetuses benefit when we vaccinate children against rubella is an additional reason for physicians to recommend that vaccine. In contrast, if rubella vaccination harmed vaccinated children for the sake of protecting infants, then it would be wrong for pediatricians to recommend it. Likewise, it is wrong for physicians to recommend that healthy children not receive the varicella vaccine for the sake of benefiting others.12
Risk factors and etiology of childhood hearing loss: a cohort review of 296 subjects
Published in Acta Oto-Laryngologica, 2020
Kai Niu, Anni Brandström, Sara Skenbäck, Maoli Duan, Inger Uhlén
It is generally assumed that genetic factors are responsible for half of the cases of congenital HL and environmental factors are responsible for other 14–30%, but the etiology is still unknown in 20–40% [1]. Regarding the genetic causes, 30% is considered to be syndromic, whereas 70% non-syndromic [7]. In less developed areas infections and neonatal complications remain the most important etiology of hearing loss (World Health Organizationg, WHO). Without well-run vaccination program, congenital rubella syndrome remains the most important cause of acquired infectious congenital HL [8], whereas in more developed areas, congenital cytomegalovirus (cCMV) has replaced rubella as the most common intrauterine infection [9]. However, this result is mostly based on those studies focused on BHL.
Risk factors associated with fetal pleural effusion in prenatal diagnosis: a retrospective study in a single institute in Southern China
Published in Journal of Obstetrics and Gynaecology, 2020
Xin Yang, Dan Yang, Qiong Deng, Fu Fang, Jin Han, Li Zhen, Dongzhi Li, Can Liao
Congenital Rubella syndrome is a devastating consequence of Rubella infection in pregnant women (Bouthry et al. 2014; Yazigi et al. 2017). The risk of fetal infection varies according to the time of the onset of maternal infection. Infection rates are highest during the first trimester, declining to a minimum of 25% at the end of the second trimester, and rising back to 100% during the last month. But even when infected by the Rubella virus, as many as 50% of CRS infants will appear normal at birth (Migliucci et al. 2011). In this study, the foetus, who showed bilateral pleural effusion with no other structural defects was diagnosed with Rubella infection by cordocentesis at 27 weeks of gestation. After the consultation, the parents chose to deliver the baby. The baby is now 5 years old, and very healthy. Another case was suspected to be with a B19 infection, the foetus showed a right pleural effusion and ascites accompanied with hepatomegaly and splenomegaly. We performed a cordocentesis and the cord blood test showed mild anaemia; the pregnant woman was advised to receive a blood transplantation, but they decided to have an abortion.