Congenital rubella is caused by the destructive action of the rubella virus on the fetus at a critical time in development. The most critical time is the first trimester. After the 4^th month, maternal rubella infection is less likely to harm the developing fetus.

The incidence of rubella syndrome has decreased dramatically since the advent of rubella vaccine.

Risk factors include lack of the recommended rubella immunization and contact with a person who has rubella. Non-immunized, non-immune pregnant women are at risk for infection and subsequent damage to the fetus.

• History of mother having rubella while pregnant (particularly in the first trimester)
• Skin rash at birth (purpura, petechiae)
• Low birth weight
• Small head size (microcephaly)
• Lethargy
• Irritability
• Deafness
• Seizures
• Cloudy corneas or white appearance to pupil (leukocoria)
• Developmental delay
• Mental retardation

Eye findings:

• Cataracts
• Glaucoma
• Retinitis

Congenital heart disease findings:

• Patent ductus arteriosus (PDA)
• Pulmonary artery stenosis
• Other heart defects

Central nervous system findings:

• Mental retardation
• Motor retardation
• Small head from failed brain development (microcephaly)
• Encephalitis
• Meningitis

Others associated findings:

• Deafness
• Low platelet count
• Enlarged liver and spleen
• Abnormal muscle tone
• Bone disease

Tests include:

• Demonstration of the virus in urine, nasopharyngeal secretions, or cerebrospinal fluid
• Antibody tests

There is no specific treatment for rubella syndrome. Care involves appropriate treatment of affected systems in consultation with your health care providers.

The prognosis for children with congenital rubella depends on the signs and symptoms present. Some findings (e.g., heart defects) can be corrected and some (e.g., nervous system damage) cannot.

As described above under Signs/Symptoms.

Vaccination prior to pregnancy can prevent congenital rubella. Pregnant women who are non-immune should avoid contact with persons with rubella.