Measles During Pregnancy: Symptoms and Treatment

July 8, 2020
Measles during pregnancy carries a number of risks for the mother and fetus. Therefore, it's important to know how the disease happens and what you can do to prevent it.

Measles is a contagious respiratory disease that can be fatal. Measles during pregnancy poses a threat to the health of the mother and the fetus, since it increases the risk of premature birth, miscarriage, and malformation in the baby.

Although you can prevent the disease through vaccination, and although mortality rates from measles have decreased by 80% in the last 10 years, in 2017 there were 110,000 deaths, mainly among children under 5 years old.

What is measles?

Measles is a disease caused by a virus in the paramyxovirus family. This virus reproduces in people’s noses and throats and is transmitted when it’s expelled by coughing or sneezing. The virus can stay in the air or land on a surface, where it remains active for several hours and can spread to people who come into contact with it.

Symptoms

Measles symptoms appear 10-14 days after exposure to the virus and manifest in different ways. They’re as follows:

  • Fever
  • Cough and sore throat
  • Rhinitis
  • Conjunctivitis
  • Stains inside the mouth called Koplik’s spots
  • Skin rash all over the body

These symptoms occur in two stages. First come the flu or cold symptoms such as fever, cough, and eye pain. After two or three days, a rash starts to appear on the skin and inside the mouth. Over a few days, the rash spreads across the body.

Measles is contagious from the first days when flu-like symptoms appear and up to 4 days after the rash appears. Without complications the disease lasts around 10 days.

A graphical representation of the measles virus in the bloodstream.
Initially, measles demonstrates common cold and flu symptoms, such as fever, cough, and eye irritation, among others. However, as it progresses, it leads to more complications.

Measles complications

The most common complications of measles are:

  • Diarrhea
  • Pneumonia
  • Encephalitis
  • Corneal ulcers

A less common case is panencephalitis, which occurs when the virus becomes lodged in the brain. There it remains passive for periods of 4 to 8 years. Eventually the virus progresses and becomes active causing serious neurological problems that lead to personality disorders, motor problems, and eventually cause death.

Read also: Encephalitis: Symptoms, Causes, and Treatment

Measles during pregnancy

Pregnant women who have never had measles or who aren’t vaccinated are susceptible to infection. Dr. Neil Silverman, a board member of the Center for Fetal Medicine and Women’s Ultrasound in Los Angeles, California, cautions that the symptoms of measles in pregnancy are often more severe and have consequences for the fetus and the pregnancy.

The main risks to the baby are:

If a woman gets measles, doctors can treat her with an injection of antibodies called  immunoglobulin serum, which helps make symptoms less severe. Doctors should administer immunoglobulin serum within 6 days of infection.

Risks of vaccination in pregnant women

The measles vaccine contains the active virus, therefore it shouldn’t be administered in pregnant women since it can be transferred to the baby if the vaccination is carried out in the following periods:

  • Starting from 6 months before pregnancy
  • During pregnancy
  • Within 30 days of birth if the baby is breastfeeding
Doctor holding out measles vaccine.
Getting the measles vaccine can reduce the risk of contracting the disease by up to 90%. However, it’s important to assess the risks during pregnancy.

If a woman has been vaccinated or has previously had measles, her antibodies pass through the breast milk to the baby, so if it becomes infected it’s very mild. However, if a woman is infected during lactation, she can pass the disease on to the baby and it’s very dangerous because the highest number of deaths from measles occurs in nursing infants – says Dr. José Tessone, from the Center for Integral Gynecology of Mexico.

Read more: 6 Vaccinations You Should Get

Vaccination

The measles vaccine is recommended starting at 12 months of age with a second dose 28 days later. Research shows that the vaccine reduces the risk of contracting measles by 90%.

In some cases with adults, doctors recommend re-vaccination. “When vaccination against measles started about 40 or 50 years ago, the immune system had to fight the virus frequently. Now that the virus is rarer, people who were vaccinated between the 1960s and 1980s could be more susceptible to the disease today,” says Dr. Silverman. However, vaccination for measles during pregnancy must follow the guidelines indicated above.

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  • Chiba, M. E., Saito, M., Suzuki, N., Honda, Y., & Yaegashi, N. (2003). Measles infection in pregnancy. Journal of Infection. https://doi.org/10.1016/S0163-4453(03)00045-8
  • Eberhart-Phillips, J. E., Frederick, P. D., Baron, R. C., & Mascola, L. (2004). Measles in pregnancy: A descriptive study of 58 cases. International Journal of Gynecology & Obstetrics. https://doi.org/10.1016/0020-7292(94)90321-2