Vaccination is the only possible method of prevention. It protects women at the age of procreation and thus decreases the risk of embryofoetal touching as long as vaccination has been taken before pregnancy.
The vaccine currently in use in our country is the combined anti-measles vaccine-mumps-rubella, ROR/MMR. Includes the anti-Rubella vaccine-a live attenuated vaccine. Do not administer when the woman is already pregnant due to the risk of foetal damage. It is recommended to avoid pregnancy within a month post-vaccination.
Children should be vaccinated with:

• The first dose of the vaccine between 12-15 months of life and then with
• The second dose at the begining of the school around the age of 5 years.

About 5-10% of children are not fully immunized after the first administration of the vaccine. As such, the second dose is also required, in which approximately 1% of children remain partially immunized.
The vaccination program performed in children reduces the virus reservoir and thus avoids the infection of pregnant women. The vaccine also protects women who want to become pregnant and who have not yet gone through the disease. In this case the vaccine should be administered before the first pregnancy or immediately after birth for future pregnancies.

If the woman who wishes to become pregnant is serologically tested for the detection of rubella anti-virus antibodies and testing shows the presence of antibodies, confirming that she has immunity (already passed through the disease), the vaccine is no longer necessary.
If the woman who wishes to become pregnant has not gone through the disease it is recommended to carry out serological checks up to 20 weeks of pregnancy. From this age of pregnancy upwords, the risk of fetus damage is very low.

Problems occur when:

• Pregnant woman comes into contact with a person suspected of having rubella– in this case the primary objective is to investigate the receptivity by blood collection to test IgG and IgM specific  antibodies. The test will be repeated after about 14-18 days, towards the end of the incubation period. The assessment of antibody titer will be made in dynamic. In absence of a rubella evoked  clinical context, the presence of specific IgM antibodies should be interpreted and announced with caution, in order not to be a false positive result. In this case it is necessary to carry out complementary techniques such as the measurement of the avidity of IgG antibodies during the first trimester of pregnancy.
• Notice the occurrence of a suspicious rash in the pregnant woman.

Diagnosis of maternal infection can only be serological.

In case of seroconversion:

• The appearance of IgM antibodies during pregnancy, although initially did not exist, in an earlier test
  Or
• The presence of IgM-type antibodies in the disease-evoking clinical context,
  = > The diagnosis of fetal infection is done by amniocentesis and by the identification of the viral RNA in the amniotic fluid. It is preferable that this investigation be done after 20 weeks of pregnancy.

Vaccination

Although the anti-rubella vaccine has been in plce since 1969, it has become accessible to underdeveloped countries since the 1990s. In Romania, in May 2004, the routine vaccination of anti-rubella (ROR/MMR) was introduced in children aged 12-15 months, and in 2003 teenage girls born in the years 1987-1988 anti-rubella were vaccinated. According to the national immunization programme, the ROR vaccine is given in two doses, the first dose of all children aged 12-15 months followed by the second dose to 5 years.

Antirubella vaccination, the only means of effective prevention, should be applied not only to children but also to women of childbearing age at least one month before being pregnant or immediately after childbirth (if they are likely to make rubella during a subsequent pregnancy). This can be done after serological testing. Particular attention should be paid to women who, due to the professional category they belong to, are at risk of getting into contact with rubella patients: medical staff, education staff and nursery / children’s homes.

Vaccination during pregnancy is contraindicated!

Administration of Immunoglobulins against rubella

Within 72 hours of the infectant contact, can be administered 20 ml intramuscularly. Symptomatology may improve, but maternal-fetal transmission is not prevented. There are documented cases of children birth with congenital rubella despite the administration of immunoglobulins.

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