One important concern for pregnant women is whether they had acquired some of the childhood illnesses before getting pregnant. Illnesses like Measles, Mumps, Rubella or German Measles, Chickenpox and Fifth Disease or Roseola Infantum are of particular interest because these seemingly mild illnesses during childhood may have serious effects on the pregnant women or their babies.
This is an extremely contagious viral infection that presents 7 to 11 days after exposure. Patients usually first manifest the “3 Cs” namely conjunctivitis (reddening of the eyes), coryza (watery nasal discharge), and cough, associated with the presence of grayish whitish dots on lining of the mouth. These symptoms are then followed with high fever and appearance of a rash that starts at the head, spreads downward, and fades in the same manner.
If the woman develops measles shortly before giving birth, there is a considerable risk of serious infection in the newborn. The virus does not seem to cause teratogenic effects, but several studies showed that there is an increased frequency of abortion, low birth weight infants, and preterm delivery. The pregnant woman can also develop measles pneumonia.
What you can do? Within 3 days of exposure, the pregnant woman can be given passive immunization with immune serum globulin 5 ml intramuscularly. Active immunization is not done during pregnancy. However, susceptible women are vaccinated routinely postpartum.
Mumps is an uncommon adult infection caused by a virus that primarily infects the salivary glands. Symptoms of fever, headache, malaise and painful enlargement of the salivary gland manifest 12 to 24 days after exposure.
Fortunately, mumps during pregnancy is no more severe than in non-pregnant adults. There is no evidence that it can increase fetal wastage and fetal anomalies.
RUBELLA OR GERMAN MEASLES
This infection by a Rubella virus presents with fever, non-itchy rash, swollen lymph nodes and joint pains, 2 to3 weeks after exposure. Rubella has been directly responsible for incalculable fetal wastage and fetal malformation known as the Congenital Rubella Syndrome. It is one of the most teratogenic infections known.
Several studies have shown 80% of women with rubella during the first 12weeks of pregnancy have a fetus with congenital malformation. This incidence decreased to54% at 13 to 14 weeks, and by the end of the end trimester, went down to 25%. Hence, the timing of maternal infection and fetal organ development determine the likelihood and severity of congenital malformations. Clinical manifestations of Congenital Rubella Syndrome include one or more of the following:
• Eye lesions including cataract, glaucoma, and other abnormalities
• Heart diseases like patent ductus arteriosus, septal defects, and pulmonary artery stenosis
• Fetal growth restriction
• Blood disorders like anemia and thrombocytopenia
• Hepatitis, liver enlargement, or yellowish discoloration of the skin
• Bone changes
What you can do? Remember, measles, mumps and rubella vaccine can not be given while you’re pregnant. So, if you haven’t had rubella before nor had immunization when you were you were still young, you should get yourself vaccinated and wait one month before trying to become pregnant. Getting vaccinated soon after giving birth is another viable option.