DIAGNOSIS OF FETAL RUBELLA INFECTION WITH REVERSE TRANSCRIPTION AND NESTED POLYMERASE CHAIN-REACTION - A STUDY OF 34 CASES DIAGNOSED IN FETUSES

OBJECTIVE: Our purpose was to develop a reliable method for prenatal d iagnosis of fetal rubella infection through the detection of viral rib onucleic acid extracted from the chorionic villi, amniotic fluid, or f etal blood in pregnant women. STUDY DESIGN: Double amplification of ru bella viral ribonucleic acid by nested polymerase chain reaction after reverse transcription was applied to samples from 34 women suspected of having rubella. The results were compared with those of serum antib ody and levels of rubella virus-specific immunoglobulin M antibodies i n fetal blood. RESULTS: Viral ribonucleic acid was revealed in 8 of 34 cases (23.5%). In the remaining 26 cases, healthy babies were born in 24, 1 was electively aborted, and 1 died in the thirty-sixth week of pregnancy of unknown causes. CONCLUSIONS: This method allowed very ear ly detection of fetal rubella infection by sampling of chorionic villi and amniotic fluid compared with evaluation of the maternal symptoms and serum antibody levels. Fetal blood was also more useful for making a diagnosis up to the twentieth week of pregnancy than was measuring rubella virus-specific immunoglobulin M antibodies.