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What Does This Rubella IgM Test Report Indicate?
Question: Hi Dr.
my wife is pregnant of 9w , during Rubella IgM test it came positive so doctor suggested to go for Torch and there we got Rubella IgG, IgM and avidity all as positive. Below are the details:
IgG 71,57 IU/ml
IgM 2.80 Ratio
Avidity 62%
Doctor is saying to repeat the test after 3 weeks, need your suggestion as we are worried.
my wife is pregnant of 9w , during Rubella IgM test it came positive so doctor suggested to go for Torch and there we got Rubella IgG, IgM and avidity all as positive. Below are the details:
IgG 71,57 IU/ml
IgM 2.80 Ratio
Avidity 62%
Doctor is saying to repeat the test after 3 weeks, need your suggestion as we are worried.
Brief Answer:
Fetal infection to be assessed
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
Rubella IgM and avidity positivity means active rubella infection. In early pregnancy, rubella infection can lead to major congenital anomalies involvong fetal eyes, ears, heart and central nervous system.
Therefore, it is mandatory to assess the presence of rubella infection in the fetus, by amniocentesis or chordocentesis at 14-16 weeks of pregnancy, and if present, then it is advisable to not to continue with the pregnancy.
There is absolutely no role of repeat TORCH test, as it is not of any help in further management and decision.
I will suggest you to consult a fetal medicine specialist for proper guidance, counselling and management.
Hope you found the answer helpful.Please do get back for further queries.
Wishing you both good health.
Regards
Dr Deepti Verma
Fetal infection to be assessed
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
Rubella IgM and avidity positivity means active rubella infection. In early pregnancy, rubella infection can lead to major congenital anomalies involvong fetal eyes, ears, heart and central nervous system.
Therefore, it is mandatory to assess the presence of rubella infection in the fetus, by amniocentesis or chordocentesis at 14-16 weeks of pregnancy, and if present, then it is advisable to not to continue with the pregnancy.
There is absolutely no role of repeat TORCH test, as it is not of any help in further management and decision.
I will suggest you to consult a fetal medicine specialist for proper guidance, counselling and management.
Hope you found the answer helpful.Please do get back for further queries.
Wishing you both good health.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok i didn't tell you about the history , she has 3 mis-carriage in past and DNC has been done for all. In past she has Rubella IgG as positive in 2012, Dec 2013 (i am attaching the reports here).
i got the below info while doing some research on Internet even the same statement is suggested by my current doctor:
A low rubella IgG avidity result indicates that there has been a recent primary rubella infection in the patient. Using this assay, maturation from low to intermediate/high avidity occurs >30 days after exposure/infection
to rubella virus. Therefore, for the interpretation of a high avidity result as a true past infection, and not a primary infection, the exposure date and serum collection date must be <30 days apart.
Primary rubella infection occurring in the first trimester of a pregnancy has a high risk of the fetus/child
developing serious congenital abnormalities (Congenital Rubella Syndrome, CRS). Reinfections / reexposure to rubella virus in a pregnant woman has a significantly lower or minimal risk of CRS. Thus differentiation of primary from past rubella infections is very important from the patient management perspective.
For example, a rubella IgM positive result would be further supported as a true acute rubella infection if the rubella avidity assay showed the presence of low avidity antibodies. Conversely, a high avidity IgG result would indicate that the IgM result may be a false positive, or that the patient has a rubella reinfection. In both of these latter cases, the risk of CRS in a pregnant woman is significantly reduced compared with a primary rubella infection occurring in the first trimester of pregnancy.
i got the below info while doing some research on Internet even the same statement is suggested by my current doctor:
A low rubella IgG avidity result indicates that there has been a recent primary rubella infection in the patient. Using this assay, maturation from low to intermediate/high avidity occurs >30 days after exposure/infection
to rubella virus. Therefore, for the interpretation of a high avidity result as a true past infection, and not a primary infection, the exposure date and serum collection date must be <30 days apart.
Primary rubella infection occurring in the first trimester of a pregnancy has a high risk of the fetus/child
developing serious congenital abnormalities (Congenital Rubella Syndrome, CRS). Reinfections / reexposure to rubella virus in a pregnant woman has a significantly lower or minimal risk of CRS. Thus differentiation of primary from past rubella infections is very important from the patient management perspective.
For example, a rubella IgM positive result would be further supported as a true acute rubella infection if the rubella avidity assay showed the presence of low avidity antibodies. Conversely, a high avidity IgG result would indicate that the IgM result may be a false positive, or that the patient has a rubella reinfection. In both of these latter cases, the risk of CRS in a pregnant woman is significantly reduced compared with a primary rubella infection occurring in the first trimester of pregnancy.
Brief Answer:
Please furnish some information
Detailed Answer:
Hi dear, please also tell whether she had rubella IgM positive in the past reports also. This information will help me to give you a more clear answer.
Regards
Dr Deepti Verma
Please furnish some information
Detailed Answer:
Hi dear, please also tell whether she had rubella IgM positive in the past reports also. This information will help me to give you a more clear answer.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
NO, she was not having negative IgM. please see the attached past reports.
and one more concern how my question came to you , during payment it was showing a doctor having 33+ years experience so i decided to shoot my question to her.
and one more concern how my question came to you , during payment it was showing a doctor having 33+ years experience so i decided to shoot my question to her.
Brief Answer:
Reinfection
Detailed Answer:
Hi dear, I have reviewed the older reports.
If her rubella IgG was positive prior to this pregnancy, that means she was immune to rubella already.
Repeat positivity of rubella IgG and IgM in this pregnancy indicates reinfection of rubella, in which the risk of congenital rubella syndrome is low, however its not nil.
I will still advise her to undergo prenatal testing to rule out fetal infection. Chorion villus sampling can be done at 11-13 weeks of pregnancy by expert fetal medicine specialist to assess the fetal rubella infection. Otherwise amniocentesis can be done at 16 weeks.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Reinfection
Detailed Answer:
Hi dear, I have reviewed the older reports.
If her rubella IgG was positive prior to this pregnancy, that means she was immune to rubella already.
Repeat positivity of rubella IgG and IgM in this pregnancy indicates reinfection of rubella, in which the risk of congenital rubella syndrome is low, however its not nil.
I will still advise her to undergo prenatal testing to rule out fetal infection. Chorion villus sampling can be done at 11-13 weeks of pregnancy by expert fetal medicine specialist to assess the fetal rubella infection. Otherwise amniocentesis can be done at 16 weeks.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Can you please suggest a good fetal medicine specialist in Delhi/Ghaziabad/Noida.
We are also from XXXXXXX but currently staying in XXXXXXX XXXXXXX
If her rubella IgG was positive prior to this pregnancy, that means she was immune to rubella already::: past report is of Dec 2013 still does it mean she is already immune with rubella.
We are also from XXXXXXX but currently staying in XXXXXXX XXXXXXX
If her rubella IgG was positive prior to this pregnancy, that means she was immune to rubella already::: past report is of Dec 2013 still does it mean she is already immune with rubella.
Brief Answer:
Detailed answer below
Detailed Answer:
Hi dear, Fetal medicine centre is good at Sir Gangaram Hospital, XXXXXXX
If you can come to XXXXXXX I will suggest you to go to the Maternal and reproductive health department in SGPGIMS, which excels in fetal medicine.You can consult personally at my clinic for guidance and referral.
Yes, once IgG positive means that the person has developed antibodies and is immune to the disease. The immunity is for lifetime.
Hope you found the answer helpful.
You can get back to me for further queries later by asking a direct question to me on the health care magic portal.
Wishing you both good health.
Regards
Dr Deepti Verma
Detailed answer below
Detailed Answer:
Hi dear, Fetal medicine centre is good at Sir Gangaram Hospital, XXXXXXX
If you can come to XXXXXXX I will suggest you to go to the Maternal and reproductive health department in SGPGIMS, which excels in fetal medicine.You can consult personally at my clinic for guidance and referral.
Yes, once IgG positive means that the person has developed antibodies and is immune to the disease. The immunity is for lifetime.
Hope you found the answer helpful.
You can get back to me for further queries later by asking a direct question to me on the health care magic portal.
Wishing you both good health.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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