Rubéole congénitale en 2010 et vaccination

Seroprevalence of rubella in pregnant women in Southern Morocco

Rubella is a generally benign but dangerous viral infection in early pregnancy, due to the teratogenic potential of the virus. Indeed, it causes spontaneous abortions, in-utero fetal death, premature labor and congenital malformations known as congenital rubella syndrome. The purpose of this study is to determine the immune status of rubella in pregnant women in southern Morocco. A prospective, multicentre study was conducted in 2017 for the detection of rubella IgG and IgM antibodies in 380 pregnant women aged 17 to 46 years, using the Architect i1000 chemiluminescent microparticle immunoassay. Eigthy for percent (84.7%) of women were seropositive. Ten percent of multiparous women remained seronegative despite recommendations for vaccination after delivery. Preventive measures against congenital rubella need to be strengthened, and vaccination is needed in non-immunized women. Vaccination awareness campaigns, especially among non-immunized multiparous women, remain essential.

Q fever and pregnancy: experience from the Limoges Regional University Hospital

INTRODUCTION

Q fever is an ubiquitous zoonosis caused by Coxiella burnetii. Its tropism for the uterus is a potential source of obstetric complications.

MATERIALS AND METHODS

We describe the obstetric consequences of Q fever diagnosed during pregnancy from a series of cases. When an antenatal diagnosis was made, antibiotic therapy with roxithromycin (Rulid(®)) was started until delivery.

RESULTS

Between 2007 and 2012, 30 patients were treated for Q fever diagnosed during pregnancy, i.e. 1.9 cases per 1000 people. The most common reasons for performing serology was intrauterine growth retardation, preterm labor and oligoamnios. Q fever was diagnosed as acute and chronic in 26 and 4 cases, respectively. Progression to chronic disease occurred in 8 % of acute forms of the diseases. The prevalence of obstetric complications was 66 %, including 10 % foetal deaths, 31 % preterm delivery and 27 % low birthweight <10th percentile. The obstetric complication rate amongst the 22 patients treated with ante partum macrolides was 60, 30 % of which involved prematurity and 33 % involved low growth. No cases of foetal death were found on treatment and no congenital malformation and placental or neonatal injury was found. No case of disease reactivation was diagnosed in the eight patients who became pregnant again.

CONCLUSION

Q fever during pregnancy is responsible for severe obstetric complications. It must be diagnosed early and its clinical forms known in order to start appropriate antibiotic therapy.