Rubella.
Rubella, also known as German measles or three-day measles, is a self-limited, mild viral illness that poses little danger to children or adults. For the developing fetus, however, infection with rubella virus is a grave threat, capable of inducing severe anomalies and permanent disability. Despite widespread vaccination programs, populations of susceptible individuals persist, among them women of childbearing age whose pregnancies remain vulnerable to congenital rubella syndrome. In the United States, the currently used rubella vaccine employs live-attenuated virus and is contraindicated in pregnancy. Nonpregnant women receiving rubella vaccination should be advised to use effective contraception for 3 months after inoculation. These warnings persist despite the fact that no clinically significant case of congenital rubella syndrome after maternal vaccination has been reported. Obstetrician/gynecologists must be familiar with rubella and the management of pregnancies complicated by exposure to the disease. Furthermore, practitioners must actively seek and vaccinate susceptible individuals to minimize this significant threat to public health.