Anaesthesia for congenital rubella syndrome

*notes taken from local master student program

Anaesthesia for congenital rubella syndrome

Overview

Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant woman who has contracted rubella during her first trimester. If infection occurs 0-28 days before conception, there is a 43% chance the infant will be affected. If the infection occurs 0-12 weeks after conception, there is a 51% chance the infant will be affected. If the infection occurs 13-26 weeks after conception there is a 23% chance the infant will be affected. Infants are not generally affected if rubella is contracted during the third trimester, or 26-40 weeks after conception. Problems rarely occur when rubella is contracted by the mother after 20 weeks of gestation.

Presentation

The classic triad for congenital rubella syndrome is:

· Sensorineural deafness - (58% of patients)

· Eye abnormalities - especially cataract and microphthalmia (43% of patients)

· Congenital heart disease - especially patent ductus arteriosus (50% of patients)

Other manifestations of CRS may include:

· spleen, liver or bone marrow problems (some of which may disappear shortly after birth)

· mental retardation 

· small head size (microcephaly)

· eye defects

· low birth weight

· thrombocytopenic purpura (presents as a characteristic blueberry muffin rash)

· hepatomegaly 

· micrognathia 

Congenital rubella serology time-line

Children who have been exposed to rubella in the womb should also be watched closely as they age for any indication of the following:

· developmental delay 

· Schizophrenia^[1] 

· growth retardation 

· learning disabilities 

· diabetes 

· glaucoma