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 Rubella and pregnancy  
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Author12 Posts
  #1

hey ppl...i was just gng thru kap notes the second and final time and as u all know it states that rubella vaccination is contraindicated in pregnancy as it is supposedly also a teratogen. But i think there was a question in uw...cant verify tht coz my subscription is over but it stated tht the female was vaccinated against rubella and now she finds out tht she's preg and in the first trimester..and the question asked for the next best step in management.

the explanation in uw stated tht rubella vaccine is no longer thot of as a teratogen and u just need to reassure the mum of tht.so acc to uw the rubella vaccine isnt dangerous.

so what do we conclude...rubella vaccination isnt all tht dangerous but u dont have to vaccinate the mother if she is antibody titer negative (not immune to rubella). i.e. Rubella vaccine isnt all tht bad if someone is accidentally vaccinated but u cant go ahead and vaccinate someone if they r not immune to rubella.

any inputs? Am i thinking right?







  #2

oops..probably shud have posted this in the Obgy forum...

hope u guys dont mind answering this one here...

thanx everyone...



  #3

If the patient received the vaccine and got pregnant, the biggest chance is: nothing is going to happen to the fetus, so we reassure the patient. But nobody has ever studied the effects of vaccinating pregnant patients to tell us if it's safe or not. Nobody will take that risk. So it's safer to vaccinate after the pregnancy ends, and to tell patients not to get pregnant during the three months following the vaccine.



  #4

Alright smiling face thanx a lot Arlete ...



  #5

in Sakala's lecture
If she is vaccinated and got pregnant earlier than 3 mo after - baby has high level of Ig (as it was infected) but no teratogenicity was documented so far in this kind of situations.



  #6

It is recommended that pregnant women not receive the MMR vaccine because it is a live vaccine. However, no fetal damage has been reported when the vaccine has been given unknowingly to pregnant women or to those who became pregnant shortly after immunization. Therefore, rubella vaccination of a woman who is pregnant or who becomes pregnant within one month should not be a reason to consider termination of pregnancy


  #7

remember Q in NMS Q bank, obs-gyn, the Q had the same scenario.......and answer was what told by babydoc4usmle.
if titres are low or absent u gonna teminate the pregnancy..

well i dont think u shud let the pregnancy continue.....although chances of abnormality is low, it still remains a cause for therapeutic abortion.
and damage to the fetus is maximum by this agent than with anything else.

i think we just can go blind with the matters explained by UW guys....
clinical science has problem, every now and then new research go on and by the time u finish reading one book the protocol has changed.

which one to follow remains controversial.


  #8

yeah i agree Drduck...and i think kap notes r less updated as compared to UW..thats y i just wanted to verify...

Thanx a lot everyone.



  #9

drduck wrote:
remember Q in NMS Q bank, ...

how old is that qbank? even last year correct ans could be not correct today (example is endocarditis profilaxis)




  #10

nod The current US immunization policy is that the risk of vaccine-associate defects is virtually negligible and should not be a reason in itself to consider termination.

Source: Kaplan Qbank new version



  #11

A registry of susceptible women vaccinated with rubella vaccine between 3 months before and 3 months after conception – the "Vaccine in Pregnancy (VIP) Registry"  No evidence of CRS occurred in the offspring of the 226 women who received the current rubella vaccine and continued their pregnancy to term. Reasonable practices in any vaccination program include asking women if they are pregnant or might become pregnant in the next 4 weeks; not vaccinating women who state that they are or plan to become pregnant. Therefore rubella immunization after pregnancy is important.


  #12

the latest uworld 2012 question also updated in 2012 says vaccination at least one month before pregnancy is fine. And the reason is the live vaccine turning into TORCH





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