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Does my sister need to abort a second time?

Q: My co-sister was infected with German measles last year so had to terminate her baby. Then her IgM level was 2.324 OD units and her IgG 58.58 IU/ml. Now she has conceived again and was asked to do a TORCH test wherein her report for rubella IgM is positive. She did another test and her IgM was 0.208 OD units. Still again she did a test and her IgM was 0.378 OD units. Does she need to abort this baby too?

A:When a pregnant woman is infected with German Measles (Rubella) for the first time in her life, then the possibility of her baby being born with defects is very high: approximately 50% during first three months and 33% during the second trimester. However, if the fetus is infected during maternal re-infection (i.e. mother being infected for the second time), the baby does not suffer. It is extremely rare to even find a minor defect in the baby born to such mothers. The reason is that re-infection is nearly never severe since the patient has developed antibodies and resistance to infection. As a matter of fact there is no difference between giving an MMR vaccine and patient becoming infected since the end result is development of immunity. Serum antibody tests are sometimes either false positive or false negative. Hence there is need to repeat them. It is quite normal for IgG to be positive in a patient who has suffered from German measles. However IgM should be repeated. In the current case, there is hardly any clinical reason to terminate pregnancy. Furthermore she is already 34 years old as per details given by you.

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