FAMILY MEDICAL CARE: VIRUS INFECTIONS DURING PREGNANCY. MATERNAL RUBELLA
Some years ago an Australian eye surgeon named Norman Gregg noticed an
apparent relationship between women who had suffered from the common
and relatively innocuous viral infection called rubella (German
measles) and certain eye abnormalities in their babies.
This prompted him to study the situation much more closely, and this was
the beginning of one of the most important discoveries of recent
times on the maternity scene. Gregg's early studies have had
world-wide repercussions of major magnitude since they were first
enunciated.
Little did he realize when he published his original report in an
Australian eye magazine that he was touching the tip of a giant
iceberg. In fact, the results are still being felt, as the general
principle is still being investigated in many allied fields.
Gregg's basic discovery was this: The mother became infected with
rubella, an innocuous disease in itself, producing a mild rash, a
few swollen glands in the neck, and maybe symptoms of a mild cold.
But, the mother's system harboured the germs in profusion. Some of
the viruses crossed over the "placental barrier" and gained access
to the developing embryo in the maternal womb.
Occurring during the vital first weeks of development, they were able to
interfere dramatically with the cell division and organ development
of the embryo. As time passed, it became very evident that the eyes
were not the only organs to be adversely affected. The ears and
heart were also prime targets.
It did not take long before Gregg's work received world-wide
acknowledgment. In fact, major epidemics of rubella are now followed
by an unfortunate wake of blind or deaf children or those with heart
defects. Indeed, se serious has the situation become that a mother
in the early stages of pregnancy who contracts rubella is considered
to be a suitable candidate for a legal termination of her pregnancy.
This is now a very widely held principle in many countries of the
world.
Of course, many women still refuse to undergo this operation, and are
often left with a deformed baby to rear. It is a sad event, but one
which still occurs in large numbers of cases throughout the world.
It has been calculated from major epidemics in many parts of the world
that a woman who is pregnant and becomes infected with rubella will
produce a congenitally deformed infant, or will spontaneously abort
in 40 per cent of cases. If the infection occurs in the first six
weeks of pregnancy, there is a 50 per cent chance of a major
congenital abnormality taking place.
The lens of the eye and the major parts of the ear develop in the embryo
between the fourth and twelfth weeks. The chief chambers of the
heart develop between the fifth and seventh weeks. Therefore, the
importance of infections during these vital times may be
appreciated.
In the light of these discoveries, it can now be stated with a fair
amount of accuracy what abnormalities may be expected. For example,
rubella occurring during the fifth and seventh weeks may produce
cataracts in the eye. (This means the lens of the eye becomes opaque
and the child is virtually unable to see.) Deafness will take place
with rubella infection during the eighth to ninth weeks. Heart
abnormalities occur with infections during the fifth and tenth
weeks. It is now as clear-cut as this.
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GENERAL HEALTH
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