Rubella and Neonatal Effects
Rubella is an essentially harmless disease that resembles measles, however, it is highly teratogenic to a developing fetus. If a pregnant woman contracts rubella, the fetus is at risk to develop Congenital Rubella Syndrome (CRS) which can result in tissue and organ damage. Proper nursing interventions and teaching should be done to prevent the spread of rubella and to lower the rates of CRS.
A History and Epidemiology for Rubella
Until the 18th century, rubella was often confused with measles and scarlet fever. In 1952 and 1958, two German scientist were able to isolate the rubella virus and it was given the name “German Measles” until 1866 when a Scottish physician gave it the name “Rubella” (Duszack, 2010). Rubella is spread through droplet transmission and contact. It replicates in the respiratory tract of the host, spreads to the lymph nodes and from there to the rest of the body (Yazdami, McGhee, & Stiehm, 2011).
Normal Sign and Symptoms of Rubella
Rubella begins as a red rash, which begins on the face and spreads quickly over the rest of the body. The rash is usually accompanied with a low-grade fever, swollen lymph nodes, however, other symptoms such as eye pain, sore throat, headache, muscular pains and nausea are also accompanying symptoms of rubella. The rash begins to coalesce and form “pinpoint papules” looking very similar to those of scarlet fever which usually last from 5-8 days (Yazdami et al., 2011).
Rubella Infection in Pregnancy
In pregnancy, the rubella virus progresses as it does in a non-pregnant woman, however, the virus affects the fetus as well. The rubella virus can cross the placenta, attacking the developing blood vessels of the fetus, which leads to organ and tissue damage which is characteristic of CRS (Yazdami et al., 2011). Rubella infection during the first sixteen weeks, in which the greatest amount of organogenesis is occurring, poses the greatest risk for the fetus. After sixteen weeks of gestation, the risk of fetal death, malformation, and miscarriage is much less. “Since the effects of CRS vary with gestational age at the time of infection, accurate gestational dating should be established, as it is critical to counseling” (Dontigny, Arsenault, & Martel, 2008, p. 155).
Consequences of Maternal Infection for Unborn Fetus
The rubella Virus is very teratogenic, and should a maternal infection occur, the developing fetus might develop congenital rubella syndrome. As said earlier, amount of injury to the developing fetus is highly dependent on what stage of development the fetus is in. The rubella virus targets all organs and tissues of the body and has a wide range of effects.
Tests to determine Maternal and Fetal Infection
Tests can be done to determine maternal or fetal infection of the rubella virus. According to Dontigny et al. (2008) if maternal infection is suspected, a serology test using enzyme-linked immunoassay (ELISA) is used to test for...