Congenital rubella syndrome overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: :Kalsang Dolma, M.B.B.S.[2]; Aditya Govindavarjhulla, M.B.B.S. [3]
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Congenital Rubella Syndrome Microchapters |
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Differentiating Congenital Rubella Syndrome from other Diseases |
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Diagnosis |
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Overview
Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant woman who has contracted rubella during her first trimester. Problems rarely occur when rubella is contracted by the mother after 20 weeks of gestation.
Pathophysiology
Congenital rubella syndrome results from the spread of infection to fetus by mother during viremic stage. Rubella virus enters fetus through the placenta and cause damage to all germ layers of fetus. This results in rapid death of some cells.
Causes
Congenital rubella syndrome is caused by rubella virus which is a single stranded RNA toga virus.
Differentiating Congenital Rubella Syndrome from other Diseases
Congenital rubella syndrome has to be differentiated from other congenital infections (TORCH infections) as they may have some overlapping features.
Epidemiology and Demographics
Congenital rubella syndrome is rare in developed countries with strong immunization programs. It is endemic in other parts of the world.
Natural History, Complications and Prognosis
Congenital rubella syndrome can cause serious birth defects and the prognosis depends on the severity of the problem. Heart defects can be corrected but neurological damage is permanent.
Diagnosis
Physical Examination
Congenital rubella syndrome is characterized by triad of sensorineural deafness, eye abnormalties (cataracts, retinopathy) and heart defects (PDA).
Laboratory Findings
Diagnostic tests used to confirm congenital rubella syndrome include serologic assays and detection of rubella virus using real time PCR.
Electrocardiogram
Electrocardiogram findings in a child of congenital rubella syndrome depends on the type of heart defect (mostly PDA) and its severity.
Chest X Ray
Chest radiograph may show increased pulmonary vascularity and cardiomegaly due to ventricular enlargement. The heart size might be normal if the shunt is small.
Treatment
Medical Therapy
There is no specific treatment for Congenital rubella syndrome. Symptoms are treated as appropriate. Management for ocular congenital rubella syndrome (CRS) is similar to that for age-related macular degeneration, including counseling, regular monitoring, and the provision of low vision devices, if required.[1]
Surgery
Treatment of newly born babies is focused on management of the complications. Congenital heart defects and cataracts can be corrected by direct surgery.[2]
References
- ↑ Weisinger HS, Pesudovs K (2002). "Optical complications in congenital rubella syndrome". Optometry. 73 (7): 418–24. PMID 12365660.
- ↑ Khandekar R, Sudhan A, Jain BK, Shrivastav K, Sachan R (2007). "Pediatric cataract and surgery outcomes in Central India: a hospital based study". Indian J Med Sci. 61 (1): 15–22. doi:10.4103/0019-5359.29593. PMID 17197734.