The clinical diagnosis of acute rubella infection in pregnancy is extremely difficult because the symptoms are not very specific nor particularly apparent,and most infectious cases are subclinical and therefore seroconversions and presence of high IgM titres is the primary mode of diagnosis of acute rubella in pregnancy.But a positive IgM doesn't means she had acute rubella infection because there were false positive with IgM antibody positive.More other confirmation test should be done such as include isolation of rubella virus from an appropriate clinical specimen.Decision for termination of pregnancy should not solely base on IgM antibody finding.In case that the family keen to continued her pregnancy should offer amniotic fluid or cord blood PCR for detection and diagnostic of perinatal infection.In this case,we report a 42-years old pregnant woman at 7 weeks’gestation complains acute onset of generalized maculopapular rash suspected of rubella infection with positive of IgM anti rubella and positive for IgG.Patient is informed that she has acute rubella infection and risk of perinatal infection and discussed about an option of termination of pregnancy.After families counselling they decided to continue the pregnancy because of a specific condition(baby will adopted by her younger brother).At 18 weeks of pregnancy we do amniotic fluid for rubella PCR RNA,and the result was negative.The pregnancy is continued with routine prenatal care.Unfortunately,she has very early preterm premature rupture of the membrane at 23 weeks and fetal death caused by umbilical cord compression,and the baby was do induction of labor and born a fetal death baby of 400 grams.A new protocol was made for management of acute rubella infection in early pregnancy.
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