Monday, March 16, 2015

The answer is d.Rubella is normally a mild self-limited illness



In the prenatal workup for a 24-year-old patient, you discover she is not immune to rubella. 

When is the best time to vaccinate her against rubella?
a. Immediately
b. In the second trimester of pregnancy
c. In the third trimester of pregnancy
d. In the early postpartum period
e. At least 4 weeks postpartum

The answer is d.  Rubella is normally a mild self-limited illness, but infection during pregnancy can result in fetal death or congenital defects known as congenital rubella syndrome (CRS). CRS is devastating, and rubella immunity is important for women considering pregnancy. If a woman is found to be rubella nonimmune, vaccination should not occur if she is pregnant or planning pregnancy in the next 4 weeks. Although the vaccine is contraindicated in pregnancy, inadvertent vaccination is not an indication for therapeutic abortion. If the patient is currently pregnant and nonimmune, she should be vaccinated as early in the postpartum period as possible.

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