bozhenka
Forum Senior
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Posts: 122
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Rubella ni 2-months pregnant woman is indication for theraputic abortion.
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| Drmos
Forum Junior
Topics: 8
Posts: 41
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Hi friends!...I think that the first step is do a serological test to see Rubella antibodies, if there is an IgG positive, no problem; but if she is negative, see if it appears any abnormality , if there is any abnormality seen in the us, recommend abortus. :!:
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| mikyro
Forum Junior
Topics: 0
Posts: 81
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PREGNANT WOMEN EXPOSED TO RUBELLA AT 2 MONTHS OF PREG. WHAT TO DOOOO???
UW SAYS REASSURE COZ THE RISK IS THEORETICAL!! I DUN KNOW WHAT USMLE WANTS US TO SAY!!!
I HATE WHEN UW DOES THIS TO ME
Here' what USMLE wants from you (you must know the following algorithm):
if exposure - inform mother first and explain her that the risk of having a malformed child is not non-negligeable. She must decide what to do next, not you !!!!. But she must understand the risks of carrying a child under these circumstances.
If mother wants abortion, give her a 24 hr period during which she have time to reflect over it. Then proceed with abortion if she doesn't change her decision.
If mother does not want abortion, follow the pregnancy to look for possible complications (both in mothe and fetus).
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the same miky - always ready to help my patients and friends as well
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| SA
Forum Elite
Topics: 21
Posts: 193
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I just want to add just two thing that check the imune status of the patient as for as rubela is concer (through vacination or previous infection) and if not imune and what ever the out come of pregnacy imune her for rubela after that
I am right mikyro :?:
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| mikyro
Forum Junior
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Posts: 81
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Yes dear, Rubella can cause cancer  . But remember the classic TORCH sy :idea: .It's heavily tested in step1/2 .
However, it is difficult to believe that there are women of reproductive age who want to become pregnant and not to do a rubella screening before procreating the child  . From all infections that may affect the fetus, rubella carries the worst prognosis :cry: . I've seen 2 children with malformations caused by this terrible infection :cry: - they were looking like monsters :cry: ; so your major role (regardless of your medical specialty) is to inform mother about the desastruous effects of rubella infection upon pregnancy and be ready to offer her the possibility of being tested for rubella Abs in her blood .
Now, here's a pratical algorithm you may use in your clinic:
You have two situations:
Scenario no.1
The woman comes to you before procreating the child:
A. She wants to be tested for rubella infection (and usually for other potential risk factors that may complicate the normal course of pregnancy)
Obtain a pertinent h/o exposure first - then check rubella ab levels in her blood;
:arrow: if present - check if recent exposure -
if recent exposure, tell her about the risks of procreating a child and advise her to delay the moment of procreation;
if old exposure, tell her that is safe to have a child but follow the pregnancy more carefully.
:arrow: if absent - tell her she is not infected but also inform her about this infection and follow the pregnancy
B. She does not know about this infection but wants further evaluation.
Respect then the above algorithm.
Scenario no.2
The woman comes to you after procreating the child
NEXT: Check rubella ab titers:
:arrow: if high - recent exposure - advise her about the necessity of a therapeutical abortion;
if mother agrees - give her a 24 hr period of further meditation and inform her about the procedure - if she still agrees: proceed with abortion;
if mother say no - follow the pregnancy very carefully to detect possible complications in both the mother and fetus.
:arrow: if low- remote exposure - this is the most difficult situation; you practically don't know when she was exposed; it depends however when the mother comes to you; because she might have been exposed at the beginning of pregnancy and comes to you in her 5 or 6 th mo; the fetus has been more than likely affected already. So, the best approach in this case is to examine the mother and the fetus in detail and look for eventual complications;
if present, inform the mother about them and decide together with her what you should do next;
if no complication, warnn the mother that complications might still occur and that it is imperative that she come to doctor be examined on a regular basis.
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the same miky - always ready to help my patients and friends as well
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| SA
Forum Elite
Topics: 21
Posts: 193
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Thanks I really need this type of discussion for my Step 2.
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