Maternal signs/symptoms. Rubella (“German measles”) is usually a mild viral illness.
Diagnosis. Serologic diagnosis requires either the presence of IgM or a significant rise in IgG antibody titer (fourfold rise over 4–6 weeks).
Fetal/neonatal effects. The risk of congenital rubella syndrome is 90% if maternal infection is acquired <11 weeks, 33% if 11–12 weeks, 11% if 13–14 weeks, 4% if 15–16 weeks, 0% if >16 weeks.
Prevention. Measles/mumps/rubella (MMR) immunization. MMR is a live vaccine and is not recommended in pregnancy.
Management. There is no treatment.
Cytomegalovirus (CMV)
Incidence. One to two percent of all births.
Transmission. Contact with body fluids, sexual contact.
Maternal signs/symptoms. Of women 20% have a non-specific viral syndrome (fever, pharyngitis, lymphadenopathy).
Diagnosis. The high prevalence of CMV seroreactivity (>50%) and multiple CMV serotypes limits the value of serologic screening.
Fetal/neonatal effects. Of infected newborns 90% are asymptomatic at birth, but many later demonstrate deafness, learning disability, and/or delayed psychomotor development.
Prevention. There is no vaccine.
Management. There is no treatment.
Human immunodeficiency virus
Incidence. Rare in developed countries, but very high prevalence in developing countries (eg, almost one in three pregnant women in South Africa is HIV positive).
Transmission. Sexual contact, intravenous drug use, vertical transmission.
Maternal signs/symptoms. Variable.
Diagnosis. Serum enzyme-linked immunosorbent assay (ELISA) and confirmatory western blot.
Fetal/neonatal effects.
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