Question

Cindy is a thirty-five-year-old volunteer in an inner-city church-sponsored preschool program. The mothers of the neighborhood are encouraged to bring their children to the program for a “time out.” Most of the children are present on an irregular basis one or two times a week.

            One day, Zach, a 2½ year-old became ill during his stay. A rash of small red spots that were not raised above the skin surface was observed during his changing, and he had a slight fever. His mother was located and encouraged to take him to the local clinic.

            Shortly after this, Cindy confirmed what she had suspected for about a month—a home pregnancy test was positive. At her visit to the obstetrician, Cindy relayed the story of Zach’s illness to the nurse when asked if she had recently been exposed to any illnesses. Cindy had not been overly-concerned about Zach’s rash but had seemed to be mildly ill herself about three weeks after that incident. The obstetrics nurse seemed to be very interested in this exposure and said that they would contact the clinic and see if Zach had visited and been diagnosed. Blood tests were also ordered for Cindy.

QUESTION 3

1. The nurse at Cindy’s obstetrician’s office seemed concerned about Cindy’s exposure. What, if any, effects could this exposure have on Cindy’s baby? (Mark all correct answers.)

   		deafness
   		Spina bifida
   		mental retardation
   		Cleft palate
   		death
   		heart defects

QUESTION 4

1. A rise in titer over 10 to 21 days and the presence of the specific IgM type antibiodies is diagnostic of a current infection in this illness. Based on the laboratory results given in this case study, Cindy’s baby is at risk for congenital rubella syndrome?

   True

   False  

QUESTION 5

1. The risk of severe birth defects is most pronounced when there is maternal infection with this virus during the first trimester of pregnancy.

   True

   False

Answer 1

Deafness, mental retardation, heart defects

Congenital rubella syndrome is an illness in infants that results from maternal infection with rubella virus during pregnancy. Congenital rubella syndrome is the name given to fetal defects caused by rubella virus infection. These include eye manifestations (cataracts, glaucoma, retinitis), congenital heart defects, hearing loss, microcephaly, bone disease, mental retardation, and diabetes.

4. True

Yes if antibodies are found in the blood that means Cindy’s baby is at risk for congenital rubella syndrome.

True

Congenital rubella syndrome can occur in a developing fetus of a pregnant woman who has contracted rubella, usually in the first trimester.