Congenital rubella syndrome laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]


Prenatal testing consists of direct isolation of the virus, viral nucleic acid quantification or detection of antibodies against rubella in fetal blood via various invasive techniques, such as amniocentesis, fetal blood sampling, and chorionic villi sampling.[1][2][3][4][5] Postnatal testing consists of isolation of the virus from throat or urine cultures[6] and detection of serology (IgG or IgM antibodies against rubella).[1][7][8][9][10][11] Other laboratory findings in infants with congenital rubella syndrome include thrombocytopenia and elevated levels of PT, PTT, and bilirubin.[12]

Laboratory Findings

Prenatal Testing

Invasive Techniques

Several invasive techniques can be done during pregnancy, depending on the gestational age. These techniques include:[1][2][3][4][5]

Technique Timing/ Gestational age at which it is performed Results Complications
Amniocentesis after 15 weeks
Fetal blood sampling after 18-20 weeks
Chorionic villus sampling after 11 weeks

Post-natal Serologic Testing

Isolation of Virus

Rubella virus can be detected from nasal, throat, urine, and blood specimens from infants with CRS.[6]

Serological Testing

Several serological investigations can be done to confirm CRS. These include detection of IgM or IgG antibodies or IgG avidity. Several methods can be used, which include ELISA, hemagglutinin inhibition (HI) and immunofluorescent antibody assay (IFA).[1][7][8][9][10][11]

Other Laboratory Findings

Other laboratory findings in infants with CRS include:[12]


  1. 1.0 1.1 1.2 1.3 De Santis M, Cavaliere AF, Straface G, Caruso A (2006). "Rubella infection in pregnancy". Reprod. Toxicol. 21 (4): 390–8. doi:10.1016/j.reprotox.2005.01.014. PMID 16580940.
  2. 2.0 2.1 Morgan-Capner P, Hodgson J, Hambling MH, Dulake C, Coleman TJ, Boswell PA, Watkins RP, Booth J, Stern H, Best JM (1985). "Detection of rubella-specific IgM in subclinical rubella reinfection in pregnancy". Lancet. 1 (8423): 244–6. PMID 2857319.
  3. 3.0 3.1 Ho-Terry L, Terry GM, Londesborough P, Rees KR, Wielaard F, Denissen A (1988). "Diagnosis of fetal rubella infection by nucleic acid hybridization". J. Med. Virol. 24 (2): 175–82. PMID 3351485.
  4. 4.0 4.1 Terry GM, Ho-Terry L, Warren RC, Rodeck CH, Cohen A, Rees KR (1986). "First trimester prenatal diagnosis of congenital rubella: a laboratory investigation". Br Med J (Clin Res Ed). 292 (6525): 930–3. PMC 1339854. PMID 3083942.
  5. 5.0 5.1 Valente P, Sever JL (1994). "In utero diagnosis of congenital infections by direct fetal sampling". Isr. J. Med. Sci. 30 (5–6): 414–20. PMID 8034496.
  6. 6.0 6.1 Center for Disease Control and Prevention Accessed on Jan 16, 2017.
  7. 7.0 7.1 Bosma TJ, Corbett KM, O'Shea S, Banatvala JE, Best JM (1995). "PCR for detection of rubella virus RNA in clinical samples". J. Clin. Microbiol. 33 (5): 1075–9. PMC 228107. PMID 7615708.
  8. 8.0 8.1 Tipples GA, Hamkar R, Mohktari-Azad T, Gray M, Ball J, Head C, Ratnam S (2004). "Evaluation of rubella IgM enzyme immunoassays". J. Clin. Virol. 30 (3): 233–8. doi:10.1016/j.jcv.2003.11.006. PMID 15135741.
  9. 9.0 9.1 Andrews N, Pebody RG, Berbers G, Blondeau C, Crovari P, Davidkin I, Farrington P, Fievet-Groyne F, Gabutti G, Gerike E, Giordano C, Hesketh L, Marzec T, Morgan-Capner P, Osborne K, Pleisner AM, Raux M, Tischer A, Ruden U, Valle M, Miller E (2000). "The European Sero-Epidemiology Network: standardizing the enzyme immunoassay results for measles, mumps and rubella". Epidemiol. Infect. 125 (1): 127–41. PMC 2869578. PMID 11057968.
  10. 10.0 10.1 Bosma TJ, Corbett KM, Eckstein MB, O'Shea S, Vijayalakshmi P, Banatvala JE, Morton K, Best JM (1995). "Use of PCR for prenatal and postnatal diagnosis of congenital rubella". J. Clin. Microbiol. 33 (11): 2881–7. PMC 228600. PMID 8576339.
  11. 11.0 11.1 Best JM, O'Shea S, Tipples G, Davies N, Al-Khusaiby SM, Krause A, Hesketh LM, Jin L, Enders G (2002). "Interpretation of rubella serology in pregnancy--pitfalls and problems". BMJ. 325 (7356): 147–8. PMC 1123673. PMID 12130613.
  12. 12.0 12.1 Ajij M, Nangia S, Dubey BS (2014). "Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis". J Clin Diagn Res. 8 (12): PD03–4. doi:10.7860/JCDR/2014/10271.5293. PMC 4316306. PMID 25654000.