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?
drshvetasm Forum Elite
Topics: 22 Posts: 285
01/23/08 - 09:10 AM
#2
oops..probably shud have posted this in the Obgy forum...
hope u guys dont mind answering this one here...
thanx everyone...
arlete Half way there!
Topics: 43 Posts: 3,106
01/23/08 - 10:38 AM
#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.
___________________ Que sera sera, whatever will be will be.
drshvetasm Forum Elite
Topics: 22 Posts: 285
01/23/08 - 03:53 PM
#4
Alright thanx a lot Arlete ...
hero Forum Guru
Topics: 41 Posts: 539
01/23/08 - 06:32 PM
#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.
jasmin Forum Junior
Topics: 7 Posts: 40
01/23/08 - 09:43 PM
#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
drduck Forum Guru
Topics: 82 Posts: 523
01/23/08 - 10:34 PM
#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.
drshvetasm Forum Elite
Topics: 22 Posts: 285
01/24/08 - 09:06 AM
#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.
hero Forum Guru
Topics: 41 Posts: 539
01/24/08 - 01:07 PM
#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)
Ivonne Find a way or make one
Topics: 58 Posts: 1,619
01/24/08 - 10:07 PM
#10
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
___________________ "Believe you can and you're half way there."
thanx a lot Arlete ... 
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.