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Other viral infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Transmission of rubella is by aerosolized respiratory droplets. The usual incubation period is 16 to 18 days with a range of 14 to 21 days (54,55). The infected individuals may shed virus for 1 week prior to and for approximately 1 week after the appearance of the typical rash. The virus may be isolated from respiratory secretions during this time, but the virus may be present in the urine and blood prior to the rash (55). A mild prodrome of malaise, low-grade fever, headache, and conjunctivitis may precede the rash by 1 to 5 days.
Preparing for the next pregnancy
Published in Janetta Bensouilah, Pregnancy Loss, 2021
Given that some infections are associated with adverse pregnancy outcomes or reduced fertility, it may be appropriate to advise women on how to decrease their risk of contracting infections during pregnancy. In particular, once they are pregnant, women should be advised to avoid handling cat litter or animal faeces, to wear gloves when gardening, to practise strict hygiene and handwashing after coming into contact with the urine, saliva or nappies of young children, and to avoid eating or handling raw or undercooked meat. Screening of both partners for sexually transmitted infections may be advisable if there are delays in conceiving, and should be seen as a positive step, as most common infections can be treated, but a high degree of sensitivity may be required with some couples. Women should ensure that they are up to date with vaccinations such as rubella.
Viral infections
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Treatment of rubella is supportive. The current recommended immunization schedule for rubella vaccine (given in conjunction with measles and mumps vaccines) is for an initial dose at 9 months, second dose at 15 months, and a third dose at 4–6 years. If rubella-specific IgM antibodies or a diagnostic rise in IgG antirubella antibodies are detected in early pregnancy, the patient should be offered prenatal counseling.
Changing Trends in Uveitis in the United Kingdom: 5000 Consecutive Referrals to a Tertiary Referral Centre
Published in Ocular Immunology and Inflammation, 2023
N. P. Jones, S. Pockar, L. R. Steeples
The relevance of Rubella virus in a substantial proportion of patients with FHU is now well established,11,12 and there is supportive evidence in that in the USA, the incidence of FHU has been found to decrease following the introduction of rubella vaccination.13 It is therefore interesting to witness the profound reduction in the incidence of this disease over a period in this clinic, where 30 years ago it was once four times more common than it is now. In the UK nearly 95% of children are rubella-vaccinated by 5 years of age, infection levels are so low that the World Health Organisation has described the disease as “eliminated” in the UK and 5 years ago routine Rubella screening in pregnancy was discontinued owing to low risk. It is likely that the incidence of FHU will reduce further. However, it will not disappear as there is evidence of other potential triggers including cytomegalovirus14 (UK incidence possibly to be increased by immigration from the Far East), and toxoplasmosis.15
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 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.