A version of this guideline for pregnant women, their partners and the public, called Routine antenatal care for healthy pregnant women. Understanding NICE guidance: information for pregnant women, their families and the public, is also available (reproduced as Appendix 1 in this version). It can be downloaded from the NICE website (www.nice.org.uk) or ordered from the NHS Response Line (087

Antenatal care : routine care for the healthy pregnant woman

This report is a compendium of all current recommendations for the prevention of measles, rubella, congenital rubella syndrome (CRS), and mumps The report presents the recent revisions adopted by the Advisory Committee on Immunization Practices (ACIP) on October 24, 2012, and also summarizes all existing ACIP recommendations that have been published previously during 1998-2011 (CDC Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices [ACIP] MMWR 1998;47[No RR-8]; CDC Revised ACIP recommendation for avoiding pregnancy after receiving a rubellacontaining vaccine MMWR 2001;50:1117; CDC Updated recommendations of the Advisory Committee on Immunization Practices [ACIP] for the control and elimination of mumps MMWR 2006;55:629-30; and, CDC Immunization of healthcare personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR 2011;60[No RR-7]) Currently, ACIP recommends 2 doses of MMR vaccine routinely for children with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry Two doses are recommended for adults at high risk for exposure and transmission (eg, students attending colleges or other post-high school educational institutions, healthcare personnel, and international travelers) and 1 dose for other adults aged ≥18 years For prevention of rubella, 1 dose of MMR vaccine is recommended for persons aged ≥12 months At the October 24, 2012 meeting, ACIP adopted the following revisions, which are published here for the first time These included: • For acceptable evidence of immunity, removing documentation of physician diagnosed disease as an acceptable criterion for evidence of immunity for measles and mumps, and including laboratory confirmation of disease as a criterion for acceptable evidence of immunity for measles, rubella, and mumps • For persons with human immunodeficiency virus (HIV) infection, expanding recommendations for vaccination to all persons aged ≥12 months with HIV infection who do not have evidence of current severe immunosuppression; recommending revaccination of persons with perinatal HIV infection who were vaccinated before establishment of effective antiretroviral therapy (ART) with 2 appropriately spaced doses of MMR vaccine once effective ART has been established; and changing the recommended timing of the 2 doses of MMR vaccine for HIV-infected persons to age 12 through 15 months and 4 through 6 years • For measles postexposure prophylaxis, expanding recommendations for use of immune globulin administered intramuscularly (IGIM) to include infants aged birth to 6 months exposed to measles; increasing the recommended dose of IGIM for immunocompetent persons; and recommending use of immune globulin administered intravenously (IGIV) for severely immunocompromised persons and pregnant women without evidence of measles immunity who are exposed to measles As a compendium of all current recommendations for the prevention of measles, rubella, congenital rubella syndrome (CRS), and mumps, the information in this report is intended for use by clinicians as baseline guidance for scheduling of vaccinations for these conditions and considerations regarding vaccination of special populations ACIP recommendations are reviewed periodically and are revised as indicated when new information becomes available

Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP).

https://www.jogc.com/article/S1701-2163(16)34916-7/pdf

Sogc clinical practice guideline

Congenital hearing loss (hearing loss that is present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing screening programmes enable early detection; early intervention will prevent delays in speech and language development and has long-lasting beneficial effects on social and emotional development and quality of life. A diagnosis of hearing loss is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus infection, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular, inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (the conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision making and guide prevention and (genetic) counselling. Management options include specific antimicrobial therapies, surgical treatment of craniofacial abnormalities and implantable or non-implantable hearing devices. An improved understanding of the pathophysiology and molecular mechanisms that underlie hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies.

Congenital hearing loss.

A number of viral infections can cause hearing loss. Hearing loss induced by these viruses can be congenital or acquired, unilateral or bilateral. Certain viral infections can directly damage inner ear structures, others can induce inflammatory responses which then cause this damage, and still others can increase susceptibility or bacterial or fungal infection, leading to hearing loss. Typically, virus-induced hearing loss is sensorineural, although conductive and mixed hearing losses can be seen following infection with certain viruses. Occasionally, recovery of hearing after these infections can occur spontaneously. Most importantly, some of these viral infections can be prevented or treated. For many of these viruses, guidelines for their treatment or prevention have recently been revised. In this review, we outline many of the viruses that cause hearing loss, their epidemiology, course, prevention, and treatment.

https://journals.sagepub.com/doi/pdf/10.1177/2331216514541361

Viral Causes of Hearing Loss: A Review for Hearing Health Professionals:

Consequences of confirmed maternal rubella at successive stages of pregnancy

Outcome of confirmed periconceptional maternal rubella

61 pregnant women in whom confirmed rubella occurred from 5 weeks before to 6 weeks after the last menstrual period (LMP) were followed up prospectively In 39, the pregnancy was terminated and the fetal tissues or mixed products of conception were examined for rubella virus In 22, the pregnancy continued to term and cord serum was tested for specific IgM antibody No evidence of intrauterine infection was found in 38 pregnancies in which the mother's rash appeared before, or within 11 days after, the last menstrual period The shortest interval at which fetal infection occurred was when the rash appeared 12 days after the last menstrual period All 10 pregnancies in which the rash appeared 3-6 weeks after the last menstrual period resulted in fetal infection: 4 of these pregnancies went to term, and all 4 infants were damaged The risk to the fetus when rubella occurs before the mother's last menstrual period is probably negligible

Outcome of Confirmed Periconceptional Maternal Rubella

Over a thousand women with confirmed rubella infection at different stages of pregnancy were followed up prospectively. Two-thirds of the women were multiparous. Pregnancy continued in 40%, and the infants were followed up after birth both clinically and serologically. The frequency of congenital infection after maternal rubella with a rash was more than 80% during the first 12 weeks of pregnancy, 54% at 13-14 weeks, and 25% at the end of the second trimester. The infection rate then rose again to reach a high figure in the last month. Follow-up was to 2 years of age--the findings in infected children being compared with those in children who had escaped infection. Rubella defects occurred in all infants infected before the 11th week (principally congenital heart disease and deafness) and in 35% of those infected at 13-16 weeks (deafness alone). No defects attributable to rubella were found in 63 children infected after 16 weeks. Continued surveillance of cases of confirmed rubella during pregnancy is recommended as an additional way of monitoring the effect of rubella vaccination.

John E. Cradock-Watson

Papers

Consequences of confirmed maternal rubella at successive stages of pregnancy

Outcome of confirmed periconceptional maternal rubella

Outcome of Confirmed Periconceptional Maternal Rubella

Consequences of confirmed maternal rubella at successive stages of pregnancy