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Rubella in pregnancy

Last edited: 4/15/2026

Overview

Rubella infection during pregnancy, known as congenital rubella syndrome (CRS), can lead to severe fetal complications including hearing loss, heart defects, and intellectual disabilities if contracted by the mother in the first trimester 1.

Diagnosis

  • Serological Testing: Detect rubella-specific IgM antibodies for recent infection; IgG avidity testing can differentiate between acute and past infection 1.
  • PCR Testing: For viral RNA detection in amniotic fluid or fetal blood to confirm intrauterine infection 1.
  • Ultrasound Monitoring: To assess fetal growth, structural abnormalities, and signs of hydrops fetalis 1.

    • Management

  • Supportive Care: Focus on managing symptoms and complications in the mother; no specific antiviral treatment for rubella 1.
  • Prenatal Monitoring: Regular ultrasounds and amniocentesis as indicated to assess fetal well-being and infection status 1.
  • Delivery Planning: Consider cesarean delivery to reduce the risk of neonatal infection if rubella rash is present near term 1.

    • Special Populations

  • Pregnancy: Susceptible women should receive rubella vaccination before conception; avoid pregnancy for at least 28 days post-vaccination 1.
  • Comorbidities: No specific management adjustments noted for comorbidities; focus remains on preventing infection and monitoring outcomes 1.

    • Key Recommendations

  • Screening for Rubella Susceptibility: Routinely screen women of childbearing age for rubella immunity before pregnancy (Evidence: Strong 1).
  • Vaccination Before Pregnancy: Vaccinate susceptible women against rubella at least one month before conception to prevent maternal infection during pregnancy (Evidence: Strong 1).
  • Avoid Pregnancy Post-Vaccination: Advise women to avoid pregnancy for at least 28 days after rubella vaccination to minimize risk of congenital rubella syndrome (Evidence: Moderate 1).

    • References

    1 Boucoiran I, Castillo E. No. 368-RUBELLA IN PREGNANCY. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2018. link

    Original source

    1. [1]
      No. 368-RUBELLA IN PREGNANCY. — Boucoiran I, Castillo E Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2018)
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