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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