Rubella in Pregnancy

Objective: To provide an update on rubella and pregnancy so that health professionals remain aware of the potentially devastating effects on the developing fetus. Outcomes: Rubella vaccination has been effective in virtually eliminating congenital rubella syndrome in Canada. Evidence: Medline, PubMed, and Cochrane Database were searched for articles published between 1985 and 2007. Values: The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. Sponsor: The Society of Obstetricians and Gynaecologists of Canada. Recommendations 1. Since the effects of congenital rubella syndrome vary with the gestational age at the time of infection, accurate gestational dating should be established, as it is critical to counselling. (II-3A) 2. The diagnosis of primary maternal infection should be made by serological testing. (II-2A) 3. In a pregnant woman who is exposed to rubella or who develops signs or symptoms of rubella, serological testing should be performed to determine immune status and risk of congenital rubella syndrome (III-A) 4. Rubella immunization should not be administered in pregnancy but may be safely given post partum. (III-B) 5. Women who have been inadvertently vaccinated in early pregnancy or who become pregnant immediately following vaccination can be reassured that there have been no cases of congenital rubella syndrome documented in theses situations. (III-B) 6. Women wishing to conceive should be counselled and encouraged to have their antibody status determined and undergo rubella vaccination if needed. (I-A)