Childhood diseases and pregnancy-mumps, measles and rubella

Whilst mumps and measles virus infections frequently occur as regional outbreaks, the incidence of rubella and the congenital rubella syndrome has dramatically declined due to effective preventionmeasures (i.e. vaccination, antenatal care, health protection at work). In pregnancy mumps and rubella virus infections are not associated with increased morbidity and mortality; however, measles may cause pneumonia and is associated with an increased risk for hospitalization. If rubella occurs during the first trimester, there is - in contrast to mumps and measles - a high risk of fetal malformations. Diagnosis of primary mumps, measles and rubella is confirmed by IgG seroconversion and detection of the virus and/or specific IgM antibodies in the presence of low IgG avidity. Invasive prenatal diagnosis is indicated in case of primary rubella virus infection before gestational week 19, laboratory confirmed reinfection before gestational week 12 and when primary rubella in the first trimester cannot be excluded due to equivocal IgM results, despite the use of supplementary tests. Prevention can be achieved by two doses of live attenuated mumps-measles-rubella vaccines, inducing a long-lasting immunity to rubella and measles, whereas mumps reinfections may still occur. The vaccination is contraindicated during pregnancy. An inadvertent vaccination, however, does not justify invasive prenatal diagnosis or termination of pregnancy.