The classic triad of congenital rubella includes all except -
Congenital rubella syndrome

 Maternal viremia associated with rubella infection during pregnancy may result in infection of the

placenta and fetus.

 The most important factor in the pathogenicity of rubella virus for the fetus is the gestational age at the time

of infection.
“In general, the earlier in pregnancy infection occurs, the greater the damage to the fetus. Maximum damage to the fetus occurs when infection is acquired in the first trimester of pregnancy”.

 Fetus infected in the twentieth week may have isolated deafness.
 Clinical manifestations

The classical triad of congenital rubella consists of cataract, deafness and congenital heart diseases.

 Laboratory diagnosis
 Isolation of virus in cell cultures of throat samples, urine or other secretions.

Normally, maternal rubella antibodies in the form of IgG is transferred to infants and is gradually last over a period of 6 months. Persistent beyond 1 year in an un vaccinated child suggests the diagnosis of congenital rubella.
Presence of Ig M antibodies is diagnostic.
PCR for rubella RNA
Cataract
Deafness
Retinitis
CHD