If the obstetric patient is infected by some viral agents in the first trimester of her pregnancy, the fetus may suffer from complications. The agents which evoke this unfavorable fetal outcome are known as TORCH viruses, among which, rubella
virus
is
notorious for serious congenital malformations. So, viral tests are needed to determine whether a woman is immune or susceptible. Recently, enzyme immunoassay(EIA) is widely used a serologic antibody testing method. But, the evaluation of the
results by
the EIA tests were not performed in obstetric patients.
Authors analyzed the results of the rubella antibody testing in obsteric patients from 1988 to 1991 in Yonsei medical center. Anti-IgM rubella antibodies were screened by 1:40 titer and anti-IgG rubella immune antibody screening by 1:1,280 titer,
During
the period, anti-IgM was positive in 6 cases(9.0%), and immune lanti-IgG was positives in 55 cases(82.1%) among 67 obstetric patients. The timing of the rubella tests was 9 cases(13.%) within intrauterine period (IUP) 12 weeks, 12 cases(18%) in
IUP
12-24 weeks, 46 cases(69%) in more than IUP 25 weeks. The clinical manifestations of pregnant women who showed positive for anti-IgM were two cases of viral exanthem and another two cases of anemia. And the fetal outcomes of these anti-IgM
positive
cases were one case of ventricular septal defect(VSD) and two cases of abortion among 6 cases. And the clinical manifestations of immune anti-IgG negative pregnant women were one case of viral exanthem, two cases of anemia and one case of
gestational
diabetes. The fetal outcomes of these immune anti-IgG negative cases were two cases of fetal death, one case of hydrocephalus and one case of hyperbilirubinemia among 8 immune anti-IgG negative cases.
From these results, it is concluded that rubella virus infection in the first trimester of pregnancy may cause a high-risk fetus. To prevent this disastrous fetal outcome, not only proper immunization of imune anti-IgG antibody but also timed
booster
vaccination after immune antibody testing should be considered in child-bearing women.
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