(rubeola embryofetopathy)

Group of malformations/anomalies of a child following maternal  rubella virus infection during pregnancy. The prevalence of this syndrome declined sharply in developed countries since the vaccination of girls became mandatory. Unlike postnatal infection, in utero infection rubella infection is chronic and the virus remains active during the whole pregnancy and even some time after birth.

The most often observed abnormalities are:

-        sensorineural hearing loss that can develop after birth (long-term monitoring)

-        ocular disorders: cataract, glaucoma

-        cardiovascular anomalies: patent ductus arteriosus, ASD, VSD, peripheral stenosis of the pulmonary arteries

-        brain anomalies: microcephaly, spastic diplegia, mental retardation; cases of central hypoventilation due to the  involvement of the respiratory centers have been described

-        sometimes, in the neonatal period: thrombocytopenia, hyperbilirubinemia with hepatosplenomegaly, meningoencephalitis

Some abnormalities are not detectable at birth and do not appear until after several months or years, such as deafness, ocular, diabetes mellitus (risk x 50 compared to the normal population), hypo- or hyperthyroidism, precocious puberty or immune dysfunction (hypogammaglobulinemia).

The severity of the clinical picture depends in large part of the time of infection

-        before the 12th week: 80 % of fetuses affected; severe cerebral abnormalities

-        between 12 and 16 weeks: 50 % of fetal injury; deafness

-        after the 16th week: fetal injury is rare

-        3rd trimester: risk of intrauterine growth retardation

Anesthetic implications:

echocardiography, and according to the anomalies of the child: deafness, spasticity etc.

References : 

-        Robert-Gnansia E. 
Syndrome de rubéole congénitale. 
Orphanet déc 2004.

-        Souki F, Shettar SS. 
Prolonged respiratory depression after general anesthesia in an adult with congenital rubella syndrome. 
A&A Case Reports 2013; 1: 46-8..

Updated: September 2019