fetal rubella syndrome

Congenital rubella syndrome is a spectrum of congenital abnormalities that result from primary maternal infection with the rubella virus. It falls under the TORCH group of infections.

It is important to note that reinfection/reactivation of maternal infection has a significantly lower risk of fetal anomalies than compared to primary infection.

Rarely congenital rubella syndrome can result in progressive diseases known as progressive rubella panencephalitis .

Clinical features

Features can include:

The first three were classically termed the Gregg syndrome.


The rate of congenital infection is worst during the 1 trimester (particularly during the first 6 weeks).

Serological markers
  • maternal rubella specific IgG
  • maternal rubella specific IgM

False positive results of IgM antibodies are common. It must be followed with IgG avidity testing to ensure if the infection is recent or not .

Radiographic features

Antenatal ultrasound

Sonographic findings are often not specific and a normal scan cannot absolutely exclude an infection. Features that may be seen include

  • evidence of hydrops fetalis if severe
  • evidence of a congenital cardiac anomaly (e.g. ASD and VSD)
  • evidence of intra-uterine growth restriction
  • sub-ependymal cysts: on cranial ultrasound

Brain manifestations :

  • small head circumference/microcephaly
  • periventricular calcifications
  • white matter hypodensity
  • ventriculomegaly 
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