Pre-natal Rosolia

Raul Osorio IGM at mail.telepac.pt
Fri Jul 12 08:37:50 EST 1996


Raffaele De Angelis wrote:
> 
> I need  medical advice on a peculiar controverse topic
> There is a 29 years old woman who had Rosolia at the age of 12.
> She is now pregnant of her second child (3rd month) and by
> microboiological analisys she was found re-infected, but not affected
> from Rosolia.
> May the fetus be infected?
> Are there specifical analisys about this?
> I am not a doctor, but doctors will read your kind advice.
> Thank you
> Raffaele

OK, Raffaele. Now we're sure what we're talking about, I can give you some information I hope 
will help you on this matter:

1. Although possible, reinfection by the Rubella virus is not common, so for starters, I would 
check if the results were accurate. Either tell your friend to repeat the test in another lab, or 
just to ask the lab director to confirm the result (if it hasn't been done yet), after telling 
him about the clinical background.

2. Routine testing for rubella, normally consists of screening and/or quantification of specific 
antibodies for Rub. virus, belonging to two different classes: IgG and IgM.
IgM antibodies normally only exist in early phases of infection, and then disappear. The 
detection of this class of antibodies normally means then, that an infection has ocurred 
recently, but in certain individuals they can persist in the blood for a long time.
IgG antibodies are the ones responsible for long-time immunity, and therefore persist in the 
blood stream for a variable lenght of time. Positive testing for IgM coupled with significant 
increase of IgG over a period of 2-3 weeks, is the best way to ensure wether there has been a 
recent infection.

3. Since only a recent infection (within the pregnancy time span) can be harmfull for the baby, 
it is of the uttermost importance to make sure all the above information is available, before 
beeing able to make a judgment.

4. There are some non-routine testing which can be done to further investigate the situation, but 
never without the full knowledge of what I described above, since this procedures have some risks 
for the baby on their own.

5. The next 2-3 weeks are a critical time-window for action, if action is to be taken, for your 
friend's pregnancy. So, if you want to, you can e-mail me a transcript of the exact lab results, 
and then maybe i can help you further, or if you want, you can fax me the report (+351 2 379 
5833).

I am the owner and director of a medical laboratory, so i should know what i'm talking about. 
Cases like this happen all the time, so don't let your friend worry too much. But I think she 
must be sure of understanding what's really happening. Then, she'll be able to make her own 
decisions. I also work in a Genetics institute, and we do a lot of pre-natal diagnosis here, so 
if you need any further advice, please feel free to mail me.

					Raul Osorio, MD



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