PRENATAL-DIAGNOSIS OF CONGENITAL-RUBELLA INFECTION FROM MATERNAL RUBELLA IN TAIWAN

Objective: To determine the frequency of intrauterine rubella infectio n in Taiwan. Methods: One hundred three pregnant women with evidence o f rubella infection were enrolled. Congenital rubella infection was di agnosed by testing specific immunoglobulin (Ig) M in fetal cord serum obtained from funipuncture or amniotic fluid culture. The fetal outcom es were evaluated by ultrasonic examination, specific antibody detecti on in cord blood at birth, and complete physical examination during ea rly childhood. Results: Prenatal diagnosis was possible in 95 of 103 f etuses, 93 by funipuncture and two by amniocentesis. Five intrauterine rubella infections were detected prenatally, and another one was diag nosed after birth, The intrauterine infection rates were 10.0, 11.8, 2 .9, and 6.5% after maternal infection at 1-10, 11-14, 15-19, and 20-29 gestational weeks, respectively. Among the six fetuses with serologic evidence of congenital infection, one had congenital rubella syndrome with sensorineural deafness, two were terminated during the second tr imester, two others were normal, and one was lost to follow-up. With t he exception of the infant with clinical congenital rubella syndrome, no evidence of rubella defects was found in the other 81 children who received follow-up to 2-4 years old. Conclusion: The risk of congenita l rubella infection in seropositive pregnant women is relatively low i n Taiwan.