CONGENITAL RUBELLA

SYNDROME (CRS)
Nur Muhammad Artha
 INTRODUCTION
▪ Congenital rubella syndrome(CRS) can occur in
a developing fetus of a pregnant woman who has
contracted rubella (GERMAN MEASLES) , usually
in the first trimester.
▪ It was discovered in 1941 by Australian Norman
McAlister Gregg.
▪ The molecular basis for the causation of
congenital rubella syndrome are not yet
completely clear, but in vitro studies with cell lines
showed that rubella virus has an apoptotic effect
on certain cell types.
 INCIDENCE
▪ Congenital rubella occurs when the rubella virus in the
mother affects the developing baby at a critical time, in
the first 3 months of pregnancy. After the fourth month,
the mother's rubella infection is less likely to harm the
developing baby.
▪ The number of babies born with congenital rubella has
decreased dramatically since the introduction of the
▪ rubella vaccine.
.
▪ Pregnant women who are not vaccinated for rubella and
who have not had the disease in the past risk infecting
themselves and their unborn baby.
 INCIDENCE
▪ If infection occurs 0–28 days before conception, the
infant has a 43% chance of being affected.
▪ If the infection occurs 0–12 weeks after conception, the
chance increases to 51%.
▪ If the infection occurs 13–26 weeks after conception, the
chance is 23% of the infant being affected by the disease.
▪ Infants are not generally affected if rubella is contracted
during the third trimester, or 26–40 weeks after
conception.
 Sign & symtoms
• The classic triad for congenital rubella syndrome
is:

• sensoryneural deafness (58% patients)

• eye abnormalities especially retinopathy, and

microphtalmia (43% patients)

• congenital heart disease- especially pulmonary

stenonsis and patent ductus arteriosus
CLASSIC TRIAD OF
CRS
Salt-and-pepper
Cataract
retinopathy
SIGNS AND SYMPTOMS
▪ Spleen, liver, or bone marrow problems (some of which
may disappear shortly after birth

▪ Intellectual disability

▪ Small head size (microcephaly)

▪ Eye defects

▪ Low birth weight

▪ Thrombocytopenic purpura

• Splenomegaly
SIGNS AND SYMPTOMS

• extramemedularry
hematopeoesis present
blueberry muffin rush
characteristic
SIGNS AND SYMPTOMS
➢Children who have been exposed to rubella in the womb should also
be watched closely as they age for any indication of:

▪ Developmental delay

▪ Autism spectrum disorders

▪ Schizophrenia

▪ Growth retardation

▪ Learning disabilities

▪ Diabetes mellitus

▪ Glaucoma
The end