As a mother-to-be, do you sometimes feel a little scared and anxious even if you catch a cold? It's very normal. Because you think so much about your precious baby in your womb. That's why, today we are going to talk about how it can affect the baby in the womb if the mother contracts rubella during pregnancy. This is what doctors call Congenital Rubella Syndrome (CRS) . Although the name is a bit long, let's understand it simply.
What is Congenital Rubella Syndrome?
Simply put, congenital rubella syndrome (CRS) is a set of health problems that occur in babies when a pregnant mother contracts rubella (also known as German measles). The word "congenital" here means "present at birth."
When the rubella virus enters the baby's body, it can affect the development of the fetus in various ways. These effects can cause problems even after the baby is born. For example, cataracts or congenital heart disease. The severity of CRS can vary from person to person. In most cases, the condition is more serious if the mother contracts rubella early in pregnancy, especially before 13 weeks.
How common is this condition?
In countries like America, the incidence of congenital rubella syndrome (CRS) is very low because the rubella vaccine is widely used. However, it is a matter of concern that, if we look at the entire world , about 100,000 CRS cases are reported every year. In our country, too, the rubella vaccine is included in the national vaccination program, so this situation has been controlled. However, awareness is very important.
What are the symptoms of congenital rubella syndrome?
The symptoms and severity of this CRS condition can vary greatly from person to person, as I mentioned earlier. The earlier in pregnancy a mother is infected with rubella, the more likely the baby is to develop severe symptoms. Sometimes, if the CRS condition is not severe, there may be no obvious signs at birth.
These are some of the first signs that can be seen immediately after the baby is born:
- Low birth weight.
- Sometimes you may see blue-purple circular spots or blisters on your baby's skin. Some people call this a "blueberry muffin rash" because it looks like the spots on a blueberry muffin.
- Purple, red, or brown spots and patches on the skin (Purpura).
- A baby's head is smaller than normal (Microcephaly).
These are other symptoms that may appear shortly after the baby is born:
- Congenital cataracts and increased eye pressure (Glaucoma).
- Congenital Heart Disease. There are different types of these. For example, holes between the chambers of the heart (Ventricular Septal Defects, Atrial Septal Defects), problems with the blood vessels in the heart (Patent Ductus Arteriosus, Peripheral Pulmonary Artery Stenosis) etc. Doctors will explain these to you in more detail.
- Developmental Delay: This means that the baby is late in crawling, sitting, walking, and talking, as appropriate for their age.
- Enlargement of the liver or spleen (Hepatosplenomegaly).
- Hearing loss. Sometimes this can progress to complete deafness.
- Hemolytic anemia is caused by the breakdown of red blood cells.
- Intellectual Disability.
- Pneumonia.
- Inflammation of the brain and meninges (Meningoencephalitis).
- Pigmentary Retinopathy.
- Bone diseases.
- Swollen lymph nodes.
Important: Babies born with Congenital Rubella Syndrome (CRS) are at increased risk of developing insulin-dependent diabetes and thyroid disease later in life.
What is the reason for this?
The main cause of congenital rubella syndrome (CRS) is when you contract rubella while you are pregnant. The rubella virus then passes from the mother through the placenta and infects the baby in the womb. The virus can damage the cells of the fetus and affect the development of various organs in the baby. This is why there are health problems that are present at birth.
Imagine what this risk looks like:
- If the mother contracts rubella within the first 12 weeks of pregnancy , CRS can affect as many as 85% of newborns.
- If infected between 13 and 16 weeks of pregnancy , it can affect up to 50% of newborns.
- If infected in the second half of the second trimester , it can affect about 25% of newborns.
Rubella is a disease caused by a virus called `(RuV)`. The main symptom is a red, itchy rash that usually starts on the face and spreads throughout the body. This is now less common in many countries due to vaccination. However, rubella is still present in some parts of the world.
Can babies with CRS spread the disease?
Yes, that's important. Doctors consider a baby with congenital rubella syndrome to be contagious for at least a year. However, if the baby is 3 months old and two rubella tests, one month apart, come back `negative` (meaning the virus is not present), then he or she is no longer contagious. Therefore, special care should be taken to protect others during that time.
How do you recognize this CRS condition?
There are several ways to diagnose congenital rubella syndrome:
- Pregnancy screening: In many countries, it is standard practice to screen for rubella and several other infections early in pregnancy. If you develop symptoms of rubella during pregnancy, your doctor will order tests to confirm the diagnosis. They will then explain to you the risk of your baby developing CRS.
- Fetal diagnosis during pregnancy: If you get rubella during pregnancy, your doctor may recommend some special tests to see if the virus has spread to your baby. For example, amniocentesis, chorionic villus sampling, and fetal blood sampling. These are more complicated tests, and your doctor will only do them if necessary.
- Diagnosis after birth: After the baby is born, a blood test (ELISA test) can be done to check for antibodies to the rubella virus in the baby's blood. A urine sample, saliva sample, or nasal swab can also be tested to see if the baby has the rubella virus. The doctor may order these tests if the mother is known to have had rubella during pregnancy, or if the baby is showing signs of CRS.
If your baby is confirmed to have rubella, the medical team will recommend several additional tests to check the baby's overall health and to find out what other health problems may be caused by CRS.
What are the treatments for this?
Unfortunately, there is no cure or direct treatment for congenital rubella syndrome (CRS). Also, some of the effects, such as hearing loss and intellectual disability, are permanent, meaning they last a lifetime. However, some symptoms, such as hemolytic anemia and interstitial pneumonia, can be managed or treated. Some heart conditions can also be treated with surgery.
Your baby's medical team will develop a specific treatment plan based on your baby's symptoms and needs. This may require the help of multiple specialists.
If my baby has CRS, what should I expect?
Congenital rubella syndrome does not affect every baby in the same way, and its severity can vary. It will take several tests and assessments to fully understand how much CRS has affected your baby. It can be a time-consuming process. But you are not alone in this journey. Your baby’s medical team will be with you every step of the way, explaining what CRS is and how it will affect your baby’s future and your family.
Can I prevent this CRS condition?
Yes! This is the most important thing. Congenital Rubella Syndrome (CRS) is a largely preventable condition!
The best way to do this is to be immunized against the rubella virus before you get pregnant. That means getting the rubella vaccine.
In Sri Lanka, we give children the MMR vaccine, which protects against measles, mumps and rubella. The first dose is usually given between 9-12 months of age and the second dose at 3 years of age (these times may vary slightly depending on the national vaccination schedule, so check with your local health officer).
If you didn't get the vaccine as a child, or if you're not sure about it, it's important to talk to your doctor about getting it now. If you get the vaccine as an adult, remember to avoid getting pregnant for 28 days (about a month) after getting the vaccine. This is very important advice.
How do I take care of my baby with CRS?
Depending on the health problems your baby has with CRS, he or she may need ongoing medical care and treatment as they grow older. It is important that you advocate for your baby and make sure they get the best medical care and support they need. This will help your baby live the best possible life.
Congenital rubella syndrome is a condition that can have a serious impact on a baby's health. But the good news is that it is largely preventable with the rubella vaccine (MMR vaccine). Whenever possible, see your doctor before you get pregnant to make sure you are protected against rubella and other infectious diseases. It is a great help for you and your baby.
The most important things to keep in mind (Take-Home Message)
There are a few things you need to remember from what we've talked about:
- Congenital rubella syndrome (CRS) is a serious condition that can occur in a baby if a pregnant mother contracts rubella.
- This can cause the baby to have various health problems (eyes, ears, heart, brain) from birth.
- The important thing is that this can be largely prevented with the MMR vaccine.
- If you are expecting a baby, ask your doctor if you are protected against rubella before you get pregnant . Get vaccinated if necessary.
- If you get the MMR vaccine, avoid getting pregnant for at least a month.
- If you are already pregnant and suspect rubella, seek medical advice immediately.
We hope this information is useful to you. A healthy family is the greatest happiness!
` Congenital Rubella Syndrome, CRS, Rubella, German Measles, Pregnancy, Rubella vaccine, MMR vaccine, Child health, Congenital diseases
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