Ring rubella in pregnancy

Ring rubella, often confused with the rubella, occur mostly in childhood and are often due to the fact that the children have intense red cheeks. The pathogen, Parvovirus B19, is not related to the rubella virus. However, like the rubella, ringworm are particularly dangerous if a pregnant woman becomes infected, and the unborn child may suffer from water retention, for example in the abdominal area, due to infectious anemia (anemia) or a hydrops fetalis: the child can die in the womb of the consequences of the infection. How common this event is and what you should know about ring rubella when you are expecting a child is given by Professor Susanne Modrow, director of the parabolic laboratory Parvoviren, Institute for Medical Microbiology and Hygiene at the University of Regensburg.

How common is the disease in adults or in pregnant women?

Prof. Modrow: According to a representative study, around 65 percent of 18 to 19-year-olds have already gone through ring rubella, and this number rises to 80 percent among over-70s. It can be assumed that about 70 percent of pregnant women are protected from infection with Parvovirus B19 because they had the infection earlier.

By what symptoms do you notice that you are infected?

Prof. Modrow: The course of the disease in children and adults varies slightly. In children, the red cheeks are striking symptoms. This is often the first sign, one to two days later, a garland-shaped rash on the arms, legs and trunk occurs, causing mild fever, lethargy, fatigue and discomfort.

Even children can suffer from arthritis. However, these are more severe when adults go through the disease, the joint pain and swelling may last for weeks to months and, in rare cases, even cause rheumatic disease. However, the classic rash is often missing.

What are the effects of ringworm in pregnancy?

Prof. Modrow: That depends on the time of the disease. In an infection to about the eighth week of pregnancy, it usually comes to a spontaneous miscarriage. Particularly problematic are infections of pregnant women between the 8th and 20th week of gestation. Then it can come about four to ten weeks after the mother's infection to the hydrops fetalis in the child. About three to nine percent of the children of mothers undergoing acute parvovirus infection during this period are affected.

Unlike rubella, children do not suffer from congenital damage: they either die in the womb or are born healthy. Women who become ill after the 20th week of pregnancy no longer need to fear for their child.

Is there a therapy if an unborn child is infected and how is this diagnosed?

Prof. Modrow: Sometimes the women themselves realize that something is wrong because the child moves less. In most cases, however, Doppler sonography determines that the child is anemic. In these cases, a blood test is immediately performed on the woman (IgM antibody + serum viral DNA) to determine if there is an acute infection.

In the child, the hemoglobin value is examined. The treatment consists of an immediate blood transfusion via the umbilical vein. With this, the child can be saved, it comes to the world healthy.

What advice can you give to a pregnant woman?

Prof. Modrow: First of all, the advice not to panic when there was contact with a person suffering from ringworm - this is often the case with one's own children, for example, bringing the illness home from kindergarten. However, this should be an immediate reason for a blood test, especially if the contact was in the 8th to 20th week of gestation.

If you have a test done before or at the beginning of your pregnancy, you can usually be completely relaxed in these situations because more than two-thirds of pregnant women have already gone through the disease and thus have lifelong immunity. The test is not paid by the coffers.

But even if you do not know if you had the Ringelrötel, there is no need to panic, because well over 90 percent of acute infections during pregnancy is not a problem. And in the other cases, there is the possibility of therapy in the unborn child.

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