Röteln und Schwangerschaft

Was ist Röteln?

Rubella (German measles) is an infection caused by the rubella virus. It is usually a mild illness causing a rash, sore throat and swollen glands. It occurs most commonly in young children but can affect anyone.

Röteln sind im Vereinigten Königreich aufgrund der Rötelnimpfung, die Teil der Masern-, Mumps- und Rötelnimpfung (MMR) ist und Kindern beider Geschlechter verabreicht wird, inzwischen selten. See separate leaflet called MMR Immunisation.

What is the congenital rubella syndrome?

If you are pregnant and have rubella (German measles) in the first few months of pregnancy, there is a high chance that the virus will cause severe damage to your developing baby. The virus affects the developing organs and the baby may be born with serious disability - this is called congenital rubella syndrome. Problems associated with congenital rubella syndrome include cataracts, deafness, and heart, lung and brain abnormalities. Having rubella infection in the first three months of pregnancy also increases your risk of having a miscarriage.

The risks of your baby developing congenital rubella syndrome are greatest in the first 20 weeks of your pregnancy, and highest of all in the first 12 weeks of pregnancy - when the baby has a high chance of catching rubella from you, in the womb (uterus). The risk is much lower if you are more than 20 weeks pregnant.

Glücklicherweise ist das kongenitale Rötelnsyndrom jetzt selten, da die meisten Frauen und Kinder gegen Röteln immun sind extrem selten im Vereinigten Königreich.

Before you become pregnant

You should have a blood test before you become pregnant. The blood test for rubella immunity checks for antibodies in your blood to show that you are immune to rubella (German measles).

• Children in the UK are immunised against rubella as part of the MMR vaccine, which falls within the routine childhood immunisation programme. Two doses are needed for full immunity and over 9 out of every 10 children under 2 years of age in the UK have had at least one dose. However, in an extremely small number of children, immunisation does not work well or does not last into adulthood. This means that some adults who have been immunised are not actually immune to rubella.

• The only way to check whether you are immune is to have a blood test.

• This blood test may be offered in routine Well Woman checks given to younger women who have not yet become pregnant. If you have not had a test, your practice nurse can arrange for this to be done.

• Prior to April 2016 a blood test for rubella immunity was offered to all pregnant women in the UK, so if you were pregnant prior to this time there should be a record of your test. Rubella immunity tests are also normally offered if you have any blood tests for infertility, or if you have had fertility treatment.

• Women who have come to the UK from overseas may not have been immunised against rubella, as countries' immunisation programmes differ. If they have not been immunised or become immune to rubella by having the disease then are then at risk of acquiring rubella in pregnancy and of having a baby with congenital rubella syndrome.

• Rubella is still widespread in many parts of the world, such as Africa and Asia. If you're planning to travel outside of the UK and are pregnant or thinking of becoming pregnant, it's worth checking your rubella status with your GP.

• Wenn Ihr Röteln-Bluttest zeigt, dass Sie nicht immun sind und Sie noch nicht schwanger sind, sollten Sie geimpft werden. Das bedeutet, dass Sie die MMR-Impfung erhalten sollten. See separate leaflet called MMR Immunisation.

When you are pregnant

It used to be routine practice to screen for rubella (German measles) antibodies in pregnancy. Since April 2016 this test has not been offered. This is because rubella infection rates are now very low in the UK and infection in pregnancy is very rare. It is also thought better to check immunity from rubella before you are pregnant, as the test can become unreliable when you are pregnant and it is much better to do it before.

Contact with suspected rubella during your pregnancy

Rubella (German measles) is normally acquired through close contact, such as being in the same room with, and close to, an infected person. If you are pregnant and come into contact with someone with (or suspected of having) rubella, you should take steps to check your rubella status. Your midwife or doctor may have a record of this (from previous blood tests). Most women are immune due to previous immunisation and will not develop rubella.

• Wenn Sie sind known to be immune (was bedeutet, dass Sie ZWEI frühere Blutuntersuchungen mit Immunitätsergebnissen haben, oder EIN Immunblutergebnis plus eine dokumentierte Impfung, oder ZWEI dokumentierte Impfdosen) dann sind keine weiteren Maßnahmen zur Vorbeugung von Röteln erforderlich. Es kann jedoch notwendig sein, auf die Ringelröteln (Parvovirus B19) getestet zu werden:

  • Ringelröteln ist eine Viruserkrankung, die der Röteln ähneln kann. Wenn Sie schwanger sind und mit einer Krankheit in Kontakt kommen, die Röteln sein könnte, dann könnte es, sofern es nicht durch Bluttests bestätigt wird, auch auf das Parvovirus B19 zurückzuführen sein. Die meisten erwachsenen Frauen sind immun gegen das Parvovirus B19, aber einige nicht. Wenn Sie vor der 14. Schwangerschaftswoche an der Ringelröteln erkranken, besteht das Risiko, dass Ihr Baby im Mutterleib (Uterus) eine Anämie entwickelt und es zu einer Fehlgeburt kommt. Daher kann Ihr Arzt, wenn Sie vor der 14. Schwangerschaftswoche mit einer Person in Kontakt kommen, die eine Infektion haben könnte, die Röteln sein könnte, auch wenn Sie gegen Röteln immun sind, einen Bluttest vorschlagen, um auszuschließen parvovirus B19 infection.

• If you are not immune to rubella, or you don't know about your immunity, and you come into contact with someone with rubella (or suspected rubella) when you are pregnant then blood tests are usually advised. These can tell if you are developing rubella before symptoms begin. Further action depends on the results of these tests. The tests are done however pregnant you are, even though congenital rubella syndrome does not develop if you have rubella after 20 weeks of pregnancy.

• See a doctor if you are pregnant and develop an illness that you think may be rubella.

• Other viruses can cause rashes similar to rubella. Most viruses do not harm the unborn child.

In the unlikely case that you are confirmed to have rubella, you will be referred to a doctor who specialises in pregnancy and childbirth (an obstetrician). The obstetrician will discuss with you the possibility of your baby having congenital rubella syndrome.

There is no effective treatment to prevent the development of congenital rubella syndrome.

How can you test for immunity to rubella?

Selbst wenn Sie eine Röteln-Impfung (Röteln) erhalten haben oder eine Röteln-Infektion hatten, besteht immer noch eine geringe Chance, dass Ihr Körper nicht genügend Antikörper gegen das Rötelnvirus gebildet hat, um Sie zu schützen. Der einzige Weg, um zu überprüfen, ob die Impfung gewirkt hat, ist ein Bluttest. Dieser testet auf Röteln-Antikörper. Da das kongenitale Rötelnsyndrom so wichtig zu vermeiden ist, if you are thinking about becoming pregnant for the first time, you should have a blood test to check that you are protected.

If you have not had the blood test then you should ask your practice nurse or doctor for the blood test if you are thinking about planning for a baby. If you are not immune then you can be immunised before you become pregnant.

In particular, women who have come to the UK from overseas and have not been immunised are at greatest risk of having a baby with congenital rubella syndrome. These women should also have the blood test.

Dr. Mary Lowth ist eine Autorin oder die ursprüngliche Autorin dieses Merkblatts.