Rubella (German Measles) During Pregnancy

What is rubella?

Rubella is a viral infection that usually causes a mild illness with rash. If you have this infection during pregnancy, it can harm the baby. It might also cause a miscarriage.

Rubella is most likely to have serious effects on your baby if you are infected during the first 3 months of pregnancy (a 25% risk). However, the baby might also be affected if you have rubella later in the pregnancy (a 1% risk). The baby may develop a group of severe birth defects called congenital rubella syndrome (CRS).

Rubella is often referred to as German measles or 3-day measles.

How does it occur?

Rubella is caused by a virus. The virus spread is through the air by coughing or sneezing. You can also get Rubella by coming in contact with mucous from someone who already has the infection. Rubella is contagious for about a week before the rash begins and then for 5 to 7 days after that.

What are the symptoms?

Adults may not have any symptoms. When symptoms occur, they appear about 2 to 3 weeks after exposure to the virus and they may include:

• a rash that starts on the chest or face, spreads to other parts of the body, and lasts 3 or fewer days (the most common symptom)
• mild fever
• runny nose and cough
• red, watery eyes
• headache
• tiredness
• joint aches
• tender, swollen lymph nodes in the back of the neck and behind and in front of the ears

Examples of possible symptoms and problems for babies infected with rubella are:

• deafness
• eye problems (cataracts)
• heart defects
• a small brain or swelling of the brain
• spleen and liver damage
• bone disease
• slow growth
• mental retardation

Some of these problems may not appear until later in a child's life.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have a blood test.

Your healthcare provider looks for eye, heart, and other problems in the newborn. Samples of fluid from the baby's nose and throat and of the baby's bowel movements and blood may be tested. Other tests may also be done.

How is it treated?

If you are pregnant and have a rubella infection, medicine called hyperimmune globulin may be given to you if you wish to continue the pregnancy. This drug may reduce your symptoms. However, the baby is still at risk of developing rubella syndrome.

There is no specific treatment for newborns infected with rubella.

How long will the effects last?

If you have a rash, it usually goes away in a few days and you recover completely. However, a rubella infection during the first 3 months of pregnancy may cause lifelong problems for the baby. Birth defects are rare if a woman has rubella after the 20th week of pregnancy.

What can I do to help prevent rubella?

If you had German measles earlier in life or have had shots against rubella, you are protected. Children over 1 year old and women of childbearing age should be vaccinated against rubella. Rubella vaccine is included in the MMR shot. Blood tests to determine whether you are immune to rubella should be done before you try to get pregnant. If you are not immune and not pregnant, you can get a rubella shot. You should then wait at least 28 days after the shot before you try to get pregnant.

You may be tested for immunity on your first visit to your healthcare provider when you are pregnant. If you are immune to rubella, there is no danger of infection. If you are pregnant and not immune to rubella, you cannot be vaccinated until you are no longer pregnant. However, you may be vaccinated while you are breast-feeding.