Korean J Obstet Gynecol.  2004 Mar;47(3):495-501.

Prenatal Diagnosis of Congenital Rubella Using Percutaneous Umbilical Blood Sampling in Pregnant Women with Rubella Infection

• Kang MS
• Song TB
• Kim YH
• Choi YY
• Yun DS

Abstract

OBJECTIVE
To evaluate the usefulness of percutaneous umbilical blood sampling (PUBS) and prevalence of fetal infection in the pregnant women with suspicious fetal rubella infection.
METHODS
Between June 1996 and May 2002 in Chonnam National University Hospital, the rubella specific IgG, IgM antibody and RT-PCR were checked in fetal blood obtained from 31 pregnant women with high risk of rubella infection. Eighteen women (58.1%) had rubella specific IgM, 11 women (35.5%) high titer of rubella specific IgG, and 2 women had a history of recent rubella vaccination within 3 months.
RESULTS
PUBS was performed in all cases, successful in 27 cases (87.1%) and failed in 4 cases (12.9%). Cardiocentesis was performed in failed cases. Performing the PUBS, fetal bradycardia was observed in 7 cases (25.9%), fetal tachycardia in 1 case (14.8%), and preterm labor in 2 cases (7.4%). Performing cardiocentesis, fetal bradycardia was observed in 1 case (25.0%), fetal tachycardia in 2 cases (50.0%), and preterm labor in 1 case (25.0%). There was no fetal death. All samples of fetal blood were positive for rubella specific IgG but rubella specific IgM was detected in only 1 case. RT-PCR was negative in all cases.
CONCLUSION
Fetal blood sampling is relatively safe and a great precaution is necessary before termination of pregnancy with suspicious fetal rubella infection and without typical maternal rash to reduce unnecessary termination of pregnancy. Several tests such as rubella specific IgM and PCR from placental villi, amniotic fluid, and fetal blood should be considered before termination of pregnancy.

Keyword

Congenital rubella; PUBS; Cordocentesis; Antenatal diagnosis

MeSH Terms

Amniotic Fluid
Bradycardia
Chorionic Villi
Cordocentesis*
Exanthema
Female
Fetal Blood
Fetal Death
Humans
Immunoglobulin G
Immunoglobulin M
Jeollanam-do
Obstetric Labor, Premature
Polymerase Chain Reaction
Pregnancy
Pregnant Women*
Prenatal Diagnosis*
Prevalence
Rubella*
Tachycardia
Vaccination
Immunoglobulin G
Immunoglobulin M