When you visit your health care provider for a pre conception visit or your first prenatal check up, he may take blood. A variety of tests are done. One of these is a rubella titer. This is a test to check for immunity to German measles.
Although rubella is rare, contracting it during pregnancy can be very dangerous to the baby. It is a particular concern in early pregnancy when the effects are most severe. When rubella is contracted early in a pregnancy, there is a risk of miscarriage, developmental disabilities and several other birth defects, also known as congenital rubella syndrome.
Fortunately, most adults in America are immune to German measles. This immunity comes from two sources, childhood exposure to rubella or a vaccine. In fact, the majority of adults in the United States have immunity to rubella. This is confirmed with the rubella titer test.
If there is a negative test result, this means you are not immune to German measles. Fortunately since most of the population is immune, the risk of contracting rubella is actually quite low. There is the occasional outbreak, but this is pretty rare. According to the Centers for Disease Control, there are fewer than a dozen cases each year.
What will happen next will depend on whether you are currently pregnant. If your blood was drawn as part of a pre conception visit, the doctor may suggest a vaccine, particularly if you work in a high risk field, such as nursing or education. If you are vaccinated, it is suggested that you wait at least three months before you conceive.
If you are already pregnant, you won’t be able to get the vaccine. It is not considered safe for pregnant women. Your doctor will discuss the option of vaccinating you in the hospital after the baby is born. This is sometimes done to protect future pregnancies. You and your doctor will make that determination based on your risk factors and health history.
Diagnosing rubella tends to be a bit tricky since the symptoms can vary. If it is a mild case, it can often go undetected. Most people experience fever, swollen lymph nodes and fatigue prior to developing the telltale rash. The rash starts on the face and then spreads.
If you think you were exposed to German measles or have any symptoms, call your health care provider. A blood test can confirm the exposure. Sometimes the test is done twice to look for changes in your antibodies. This would suggest that the exposure was recent and the baby may be at risk.
What happens next depends on several factors. One is the week of your pregnancy. If you are more than 20 weeks pregnant, there is little risk to the baby. If you are fewer than 20 weeks, there may be cause for concern. There isn’t any known treatment, but some doctors will give a shot of immune globulin. This won’t prevent infection, but can help reduce the risk of birth defects.
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