CONGENITAL RUBELLA SYNDROME (CRS)

DR.VAMSHIKRISHNA DUSSA, MD(HOMOEO).J.S.P.S GOVT HOMOEO MEDICAL COLLEGE,HYDERABAD.

INTRODUCTION

▪ Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant woman who has contracted rubella (GERMAN MEASLES) , usually in the first trimester.

▪ It was discovered in 1941 by Australian Norman McAlister Gregg.

▪ The molecular basis for the causation of congenital rubella syndrome are not yet completely clear, but in vitro studies with cell lines showed that rubella virus has an apoptotic effect on certain cell types.

INCIDENCE

▪ Congenital rubella occurs when the rubella virus in the mother affects the developing baby at a critical time, in the first 3 months of pregnancy. After the fourth month, the mother's rubella infection is less likely to harm the developing baby.

▪ The number of babies born with congenital rubella has decreased dramatically since the introduction of the rubella vaccine.

▪ Pregnant women who are not vaccinated for rubella and who have not had the disease in the past risk infecting themselves and their unborn baby. .

INCIDENCE

▪ If infection occurs 0–28 days before conception, the infant has a 43% chance of being affected.

▪ If the infection occurs 0–12 weeks after conception, the chance increases to 51%.

▪ If the infection occurs 13–26 weeks after conception, the chance is 23% of the infant being affected by the disease.

▪ Infants are not generally affected if rubella is contracted during the third trimester, or 26–40 weeks after conception.

SIGNS AND SYMPTOMS

▪ The classic triad for congenital rubella syndrome is:▪ Sensorineural deafness (58% of patients)▪ Eye abnormalities especially retinopathy, cataract

and  microphthalmia  (43% of patients).▪ Congenital heart disease — especially pulmonary

artery stenosis  and  patent ductus arteriosus (50% of patients).

CLASSIC TRIAD OF CRS

SIGNS AND SYMPTOMS

Salt-and-pepper retinopathy Cataract

SIGNS AND SYMPTOMS

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

▪ Intellectual disability▪ Small head size (microcephaly)▪ Eye defects▪ Low birth weight▪ Thrombocytopenic purpura▪ Splenomegaly

SIGNS AND SYMPTOMS

▪ Extramedullary hematopoiesis, presents as a characteristic  blueberry muffin rash

SIGNS AND SYMPTOMS

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

▪ Developmental delay▪ Autism spectrum disorders▪ Schizophrenia▪ Growth retardation▪ Learning disabilities▪ Diabetes mellitus▪ Glaucoma

The end