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What if I am exposed to measles without being aware of it, only to discover that I have got the infection?
Again, this is a rare occurrence, for the reasons explained above. However, when this happens, the infection can be serious, needing hospital admission and isolated nursing. Measles pneumonia, which may be complicated by secondary bacterial pneumonia, is the most likely problem.
The potential complication of measles infection in pregnancy is that it could provoke labour and lead to premature delivery. If this happens, attempts may be made to suppress the contractions, provided the mother is not too ill and there are no features of fetal distress. These efforts are not always successful.
If I know I am not immune to measles, can I be vaccinated during pregnancy?
No. Vaccination for measles employs a live (weakened) virus and no such vaccination can be given during pregnancy.
If I was vaccinated for measles during pregnancy, before I discovered that I was pregnant, what should I do?
Most doctors will check a woman’s menstrual history before vaccinating her against measles. Some will go so far as to perform a pregnancy test, to avoid any mishap. However, cases of vaccination during pregnancy have been reported. No adverse effect to the babies have been observed and therefore, even in such an accident, there is really no question of recommending termination of pregnancy.
Rubella (German measles) and pregnancy
If I am exposed to Rubella (German measles) in pregnancy, what should I do?
Most mothers born after the mid-1960s will have been immunized and over 90 per cent of these will have acquired long-term immunity. A fair proportion of the rest will have had the infection and acquired immunity that way. If you are unsure whether you are immune or not, you should see your doctor promptly to have a blood test to establish your immune status.
If I am immune to Rubella, can my baby be affected by my exposure to the infection during pregnancy?
No. You are immune, so you cannot acquire the infection and therefore cannot pass it on to the fetus.
If I am found not to be immune, is there anything that can be done to help the fetus?
If you acquire the infection during pregnancy, there is nothing that can be done to influence what happens to the baby. Since most Rubella infections are unrevealed, if you have been exposed, blood tests will be required to confirm whether the infection has indeed been passed on to you.
What are the effects on the fetus?
Rubella causes what is called "Congenital Rubella Syndrome". The earlier in pregnancy the infection is acquired, the more severe the features of the syndrome. They may include some or all of the following:
- jaundice
- enlargement of the spleen
- cataracts
- deafness
- heart disease
- a small head, together with mental retardation
- thyroid dysfunction.
The syndrome could be so severe as to make the quality of life of the child questionable. Most (over 70 per cent) of babies will be affected, to varying degrees, if the mother acquires the infection in the first twelve weeks of pregnancy.
As there appears to be a window for a few babies to escape infection, is there any test that can identify babies that have been affected and those who have escaped?
Yes, but unfortunately this can only be done and is only reliable after twenty weeks of gestation. A cord blood sample is taken and analysed to establish whether the infection was passed to the fetus. This procedure does carry a small but significant risk of killing the fetus or provoking a miscarriage.
