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Chapter 007. Medical Disorders during Pregnancy (Part 8)

Rubella (See also Chap. 186) Rubella virus is a known teratogen; first-trimester rubella carries a high risk of fetal anomalies, though the risk decreases significantly later in pregnancy. Congenital rubella may be diagnosed by percutaneous umbilical blood sampling with the detection of IgM antibodies in fetal blood. All pregnant women should be screened for their immune status to rubella. Indeed, all women of childbearing age, regardless of pregnancy status, should have their immune status for rubella verified and be immunized if necessary. The incidence of congenital rubella in the United States is extremely low. Herpesvirus (See also Chap. 172) The acquisition. | Chapter 007. Medical Disorders during Pregnancy Part 8 Rubella See also Chap. 186 Rubella virus is a known teratogen first-trimester rubella carries a high risk of fetal anomalies though the risk decreases significantly later in pregnancy. Congenital rubella may be diagnosed by percutaneous umbilical blood sampling with the detection of IgM antibodies in fetal blood. All pregnant women should be screened for their immune status to rubella. Indeed all women of childbearing age regardless of pregnancy status should have their immune status for rubella verified and be immunized if necessary. The incidence of congenital rubella in the United States is extremely low. Herpesvirus See also Chap. 172 The acquisition of genital herpes during pregnancy is associated with spontaneous abortion prematurity and congenital and neonatal herpes. A recent cohort study of pregnant women without evidence of previous herpes infection demonstrated that 2 of the women acquired a new herpes infection during the pregnancy. Approximately 60 of the newly infected women had no clinical symptoms. Infection occurred equally in all three trimesters. If herpes seroconversion occurred early in pregnancy the risk of transmission to the newborn was very low. In women who acquired genital herpes shortly before delivery the risk of transmission was high. The risk of active genital herpes lesions at term can be reduced by prescribing acyclovir for the last 4 weeks of pregnancy to women who have had their first episode of genital herpes during the pregnancy. Herpesvirus infection in the newborn can be devastating. Disseminated neonatal herpes carries with it high mortality and morbidity rates from CNS involvement. It is recommended that pregnant women with active genital herpes lesions at the time of presentation in labor be delivered by cesarean section. Parvovirus See also Chap. 177 Parvovirus infection human parvovirus B19 may occur during pregnancy. It rarely causes sequelae but susceptible women .