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A study of rubella virus infection during pregnancy.

OBJECTIVE
To investigate the status of rubella virus (RV) infection in pregnant women and evaluate the effect on fetus of RV infection during pregnancy.


METHODS
Enzyme linked immunosorbent assay (ELISA) was used to detect the RV specific IgG and IgM antibodies in 1 471 serum samples of pregnant women, and reverse transcription polymerase chain reaction (RT-PCR) was employed to detect RV RNA in placental and fetal tissues obtained after termination of pregnancy, tissue samples of 3 dead fetus or artificial labor fetus were also made into tissue slices and observed by electron microscope.


RESULTS
RV IgG was detected positive in 76.1% of cases (1 119/1 471) and 7.4% of cases (109/1 471) were RV IgM-positive, 14.1% (208/1 471) of cases were found to be double-negative of RV IgG and IgM while 2.4% of cases (35/1 471) were RV double-positive of IgG and IgM. Among seven follow-up pregnant women, two cases developed fetal death and one woman received labor induction voluntarily. Rubella virus particles were detected in myocardial cells of 1 induced fetus. In addition, RV particles were also detected in placenta, myocardium, liver and brain in 2 dead fetus.


CONCLUSIONS
A part of the population under study was susceptive to RV and about 7.0% was infected by RV during pregnancy. Among these infected women, intrauterine infection may have occurred and caused varied degree of hurt to fetus or resulted in serious congenital rubella syndrome (CRS). These findings suggest that RV IgG and IgM should be monitored repeatedly during pregnancy in order to prevent the development of CRS and assure aristogenesis.