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 hurt the baby. It might 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. However, the baby might also be affected if you have rubella later in the pregnancy. The baby may develop a group of severe birth defects called congenital rubella syndrome. The health effects of congenital rubella are often quite serious.
Fortunately, congenital rubella syndrome is very rare in the US. It happens more often in babies whose mothers are from other parts of the world where vaccination against the infection is less common.
Rubella is often referred to as German measles or 3-day measles.
How does it occur?
The rubella virus is spread through the air by coughing or sneezing. Rubella is contagious for about a week before and 5 to 7 days after the rash begins.
What are the symptoms?
Adults may not have any symptoms. When symptoms occur, they start about 2 to 3 weeks after exposure to the virus. They may include:
- a rash that starts on the chest or face, spreads to other parts of the body, and lasts 3 or less (this is 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
- intellectual disability
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 will look 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 having 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 in infected with rubella after the 20th week of pregnancy.
How can I help prevent rubella?
If you had German measles earlier in life or have had shots against rubella, you are protected. (Rubella vaccine is included in the MMR shot.) Women of childbearing age should check with their healthcare provider to make sure they are protected before they get pregnant. Blood tests can be done to see if you are immune to rubella. If you are not immune and not pregnant, you can have the shot to protect you and any children you might have in the future. To be safe, you should avoid getting pregnant for 3 months after the shot. However, there has never been a reported complication of pregnancy for mothers who get pregnant sooner than this after the shot.
If you are pregnant, you may be tested for immunity at your first prenatal visit with your healthcare provider. If you are immune to rubella, there is no danger of infection. If you are not immune to rubella, you cannot be vaccinated until you are no longer pregnant. You can get the shot after your baby is born and before you leave the hospital to protect any more children you might have. It is safe to get the shot while you are breast-feeding.
