Both rubella and PVB19 present with a rash, and differentiation between the two continues to present diagnostic problems. Investigation of a pregnant women who presents with a rash, or history of contact with rash, should be performed appropriately to confirm or exclude a diagnosis of either recent rubella or parvovirus B19 infection.
For women who present with a rash, investigation for acute rubella or parvovirus B19 infection should always be undertaken, irrespective of vaccination history (rubella) or prior antibody testing (rubella or parvovirus B19).
Ultrasound markers of rubella infection include:
| Marker | Description |
|---|---|
| Fetal growth restriction | A prominent feature in cases of rubella, CMV and syphilis (see section on syphilis for more detail) |
| Cardiothoracic lesions | Clinical features of congenital rubella syndrome include several cardiac defects, primarily pulmonary valvular stenosis and ventricular septal defect |
| Lesions of the gastrointestinal tract | Most congenital infections show abnormal features of the liver, spleen and bowel on ultrasound The most common sonographically detected markers are peritoneal hyperechogenicities and/or hyperechogenic fetal bowel |
| Lesions of the head | Eye defects are observed with congenital rubella (although this is less common now, with the use if rubella vaccine in childhood) |