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Sera of 2000 pregnant women attending the antenatal clinic of the Aga Khan University Hospital were tested for rubella antibodies.
Rubella (German measles) has been directly respon­sible for much pregnancy wastage and severe congenital malformation in the live born infant including congenital deafness, mental retardation, cerebral palsy, eye defects. Routine antenatal screening for rubella on all women attending the antenatal clinic at the Aga Khan University Hospital (AKUH), Karachi was carried out. Congenital rubella syndrome is an important cause of preventable congenital defects in the newborn.
This journal is a member of and subscribes to the principles of the Committee on Publication Ethics. Worldwide efforts have been made to reduce the risk of foetal anomalies by immunizing the susceptible female population of child bearing age. Jack Fernandes (Assistant Librarian, AKUH) for his help and Miss Nargis Amirali for her secretarial assistance. Isolation and identification of the virus * specimens : throat and nasal swabs and nasal washes * inoculated on primary human and monkey kidney cells -> isolates typed by IF or hemadsorption inhibition or HI 2.
In Great Britain the protective strategy employed is to allow wild rubella virus to circulate among children so that ap­proximately 50% of women can enter their child-bearing years with naturally acquired immunity.
Three ml of blood was drawn from patients at their first visit to the antenatal clinic and rubella IgG and 1gM antibodies screening tests were done by the ELISA Technique (Rubazyme, Abbott Laboratories).
Immunization of all school girls aged 10-14 years is then employed with the aim of giving vaccine induced immunity to the remaining 50% (Department of Health & Social Security 1970).

Ours is a descriptive study of rubella immunity status in women visiting the antenatal clinics at a private hospital.
Prevalence of antirubella antibodies in pregnant and pre pubertal females; a preliminary study. Incidence of poliomyelitis in pregnancy; its relation to maternal age, panty and gestational period. We conclude that apart from vaccination of all young children greater attention should be paid to immunization of women of child-bearing age (JPMA 40 :102,1990).
In addition, vaccination is offered to all women of child-bear­ing age who have been shown to lack antibodies against rubella,1 Overall the incidence of congenital rubella has been declining over the past few years due to active immuniza­tion programmes in the Western countries. Prevention of congenital rubella in Iceland by antibody screening and immunization of seronegative females.
Therefore this data cannot be extrapo­lated to draw conclusions about the immunity status in the whole female population of Pakistan. Further studies are required, but this can serve as a model to conduct similar studies in defined geographical areas. 3 There is little epidemiological data available in Pakistan regarding susceptibility to rubella in pregnancy and the incidence of congenital rubella syndrome in the new born.
Of the two studies carried out in Pakistan the immunity to rubella in 262 married women, was 72%4 in one while in another it was 77% in pregnant and 51.7% in pre-pubertal females5.
Two previous studies4,5 have shown a susceptibility rate of 28% in married women and 23% in pregnant women.

Parity has been shown to be an important factor in assessment of rubella status and may reflect postpartum immunization.
11 Another factor is the exposure of parous women to young children in their own and in neighbouring households. This source has previously been shown to explain the association between poliovirus infection and parity12 and is a factor which must be controlled in further studies of rubella. The implications and consequences of the congem­tal rubella syndrome for the foetus are well known13 and can present substantial physical, emotional and financial hardships for the children and the family.
In order to reduce the number of patients at risk, considerable efforts would be required and, until high vaccination rates become the rule throughout the country, the seropositivity rates of women seeking antenatal care may not improve. The first one is vaccination of all young children in order to prevent the spread of rubella to adult pregnant women.
The other is to vaccinate all teenage girls, thus giving individual protection against rubella during their fertile period.

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