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Dr Marlena du Toit

Information about RUBELLA during pregnancy. PDF Print E-mail

Rubella, or German measles, is most dangerous to your baby if you catch it during the first 16 weeks of pregnancy. Rubella can cause miscarriage, stillbirth, or birth defects in unborn babies, such as:

  • deafness,
  • brain damage,
  • heart defects, and
  • cataracts.

This is called congenital rubella syndrome and it is transmitted to the baby through the placenta. Rubella is now a rare condition because people were either vaccinated at school, or as part of the childhood MMR vaccine.

Rubella is transmitted by coughs and sneezes, and is very contagious. Being immune to rubella ensures that your baby is very unlikely to be affected if you come into contact with the infection. You will have a blood test to check your rubella immunity as part of your antenatal tests. This will usually be at your first check-up.

Rubella immunity test

If you are planning to get pregnant, you should have the rubella immunity test first. Even if you were vaccinated at school, immunity does not last as long as previously thought, and the effects of the vaccine may have worn off.
If you are not immune, you cannot have the jab while pregnant because the vaccination contains a live virus, which could cause rubella infection in the baby. For the same reason, you should not become pregnant for at least a month after having your rubella jab.
Symptoms of rubella are mild and include fever, headache, joint pains and sore throat. A distinctive red-pink rash usually appears shortly after the glands swell.

Risks during pregnancy

The risks from getting rubella during the different stages of pregnancy are outlined below.

  • First trimester (weeks 0 to 13): If you contract rubella during the first trimester, there is a very high risk (up to 90%) that your baby will be affected. The earlier in your pregnancy that you catch rubella, the greater the risk to the baby.
    After week 10, the risk to the baby is reduced, however, they may develop problems with their sight or hearing, which may not become apparent until they are older.
  • Second trimester (weeks 14 to 26): In weeks 14 and 15, there is still a risk to the baby. They may develop problems with their sight or hearing that may not become apparent until they are older.
  • Third trimester (week 27 to birth): After week 16, the risk to the baby is low.

If you are pregnant and you know that you are not immune to rubella, you must keep away from anyone who has rubella, particularly during your first 16 weeks of pregnancy.
If you come into contact with someone with rubella, you should inform your gynaecologist immediately. They will be able to diagnose rubella and may offer you a test to see if your baby has been affected.
If your baby has been affected by rubella, you will be encouraged to have some counseling and talk to your gynaecologist, a nurse or midwife. There are a number of options available to parents who are expecting a baby affected by congenital rubella syndrome.
N.B. If you are having chemotherapy, or if your immune system is low for another reason, or if you are allergic to the medicines neomycin, or polymyxin, you should not have the rubella vaccination.