Fetal and placental pathology in gestational rubella

During the course of a recent rubella epidemic in Israel, 45 cases of interruption of pregnancy were studied. These included 32 cases with clinical evidence of rubella (14 interrupted during the third month and 15 during the fifth or sixth months) and 13 cases (3 interrupted during the third month and 10 during the fifth to sixth months) in whom close contact with rubella occurred. Seventy other placentas and 32 fetuses of the same age served as controls. Of 14 cases with clinical rubella in which pregnancy was interrupted during the third month (and only the placentas were examined), typical placental damage was found in 8. Of 18 cases of clinical rubella in which pregnancy was interrupted at 5 to 6 months, 9 of the fetuses exhibited various malformations, and 10 placentas were damaged. Of the 13 cases of close contact with rubella, 10 fetuses were examined, and 2 were malformed; all the placentas were studied, and 2 were found to have abnormalities typical of those caused by rubella. A positive correlation between maternal rubella antibody levels and placental and fetal injuries was usually found. The close correlation between fetal anomalies and placental damage is discussed.