مقالات پذیرفته شده در سومین کنگره بین المللی زیست پزشکی
Pregnancy measles
Pregnancy measles
Anis Jalali Bajgiran,1sheida jalali bajgiran,2,*
1. anis jalali bajgiran Student Research Committee, School of Nursery and Midwifery, Mashhad Islamic Azad University, Mashhad, Iran. 2. sheida jalali bajgiran Student Research Committee, School of Nursery and Midwifery, Mashhad Islamic Azad University, Mashhad, Iran.
Introduction: It is a childhood disease whose prevalence in North America has declined markedly since childhood rubella vaccination began. In the absence of pregnancy, the disease usually manifests itself clinically as a mild self-limiting infection. However, during pregnancy, the virus can have potentially harmful effects on the developing fetus. It is directly responsible for the extraordinary lesions and severe congenital malformations. The present paper examines some of the consequences of rubella during pregnancy
Methods: Accurate diagnosis of acute primary rubella infection during pregnancy is essential and requires serologic testing of a significant number of subclinical cases. Serology by ELISA is convenient, sensitive and accurate for the evaluation of rubella specific IgG and IgM. The diagnosis of rubella infection is as follows:
Four-fold increase in rubella IgG antibody titers between acute and recovered serum samples
A positive serologic test for rubella specific IgM antibody
A positive rubella culture (isolation of rubella virus in a clinical patient sample).
Rashes or rashes should be repeated two to three weeks later. Viral cultures from the nose, blood, throat, urine, or cerebrospinal fluid may be positive from one week before to two weeks after the appearance of rashes or rashes.
Results: Vertical infection of the mucosa by the rubella virus can have disastrous effects on the developing fetus and may result in spontaneous abortion, fetal infection, stillbirth or restriction on fetal growth.
Congenital rubella syndrome (CRS) is a manifestation of prenatal infection by rubella virus. Infection affects many fetal systems. The risk of (CRS) disorders varies according to the gestational age at which maternal infection occurs. Therefore, advice on the dangers to the fetus and the management of pregnant women should be provided separately.
Many children born with (CRS) in later stages of life show persistent deficits in the motor nervous system. Lung inflammation, diabetes, thyroid dysfunction, and other progressive pan-encephalitis are other sequelae of (CRS).
Vaccine:
Although reinfection may occur in immunized pregnant women, re-infection only results in an 8% risk of (CRS) in the first trimester of pregnancy.
The rubella vaccine is usually well tolerated. Side effects of vaccination, although rare, include arthritis, joint pain or arthralgia, rash or cutaneous rash, adenopathy, and fever. The actual incidence associated with the acute arthritis vaccine or joint pain in immunocompromised women is 5%. However, there is no evidence of an increased risk of emerging chronic arthritis or neurological conditions in women receiving the RA27 / 3 rubella vaccine. There are no epidemiological or epidemiological data suggesting association between (CRS) or autism with the rubella vaccine.
Contraindications for measles vaccination include: fever; Immunodeficiency; A history of an anaphylactic or anaphylactic reaction; To neomycin, and pregnancy. The rubella vaccine virus has the potential to cross the placenta and infect the fetus. However, there are no reports of (CRS) in the offspring of women who were inadvertently vaccinated during pregnancy. Therefore, termination of pregnancy is not recommended for these patients. Given the potential risks to the fetus, women are advised not to become pregnant for 28 days after immunization.
The vaccine can be given safely after delivery to pregnant women and to the offspring of pregnant women, as the infection is not transmitted to newly vaccinated people. Breastfeeding is not contraindicated. The vaccine can also be administered in conjunction with other forms of immunoglobulin, such as Rh-immunoglobulin .
Conclusion: Infection with rubella in a pregnant woman may have devastating effects on the developing fetus. The main pillar is prevention, global immunization of all Canadian infants, and identification and immunization of exposed migrant women. The infection should be diagnosed as soon as possible. Even pregnant women with IgG positive should avoid exposure to rubella during the first two trimesters of pregnancy. Women should be counseled about the potential risks of vertical transmission and termination of pregnancy, especially if the initial infection occurs before week 16 of pregnancy. Unfortunately, there is no intrauterine treatment for infected embryos. Therefore, prevention is the best strategy to eliminate all cases of congenital rubella syndrome (CRS).