23 years old female comes to OG, because she thinks pregnant. She missed her last two cycles and she feels different. Urine pregnancy test was positive. On USG, the pregnancy was confirmed to be 12 weeks. She is very concerned because she received Measles Mumps Rubella (MMR) vaccine 4 months ago and she was told to wait for 3 months to conceive. The pregnancy is desired. The most appropriate step is
Answer: a) Vaccine risk is minimal, not itself a reason to terminate the pregnancyThe live attenuated Jeryl-Lynn vaccine strain is part of the MMR vaccine--measles, mumps, and rubella--and is contraindicated in pregnancy.No malformations attributable to MMR vaccination in pregnancy have been reported, but pregnancy should be avoided for 30 days after mumps vaccination.The vaccine may be given to susceptible women postpartum, and breast feeding is not a contraindication.MMR vaccine should be offered to nonpregnant women of childbearing age who do not have evidence of immunity whenever they make contact with the health-care system.Vaccination of all susceptible hospital personnel who might be exposed to patients with rubella or who might have contact with pregnant women is important.Rubella vaccination should be avoided 1 month before or during pregnancy because the vaccine contains attenuated live virus.Although there is a small overall theoretical risk of up to 2.6 percent, there is no observed evidence that the vaccine induces malformations (MMR vaccination is not an indication for pregnancy termination). Prenatal serological screening for rubella is indicated for all pregnant women. Women found to be nonimmune should be offered the MMR vaccine postpartum.Despite native or vaccine-induced immunity, subclinical rubella maternal reinfection may develop during outbreaks. And although fetal infection can rarely occur, no adverse fetal effects have been described.
Vaccine risk is minimal, not itself a reason to terminate the pregnancy
Vaccine risk is nil, termination is completely inappropriate
Vaccine risk is high, termination should be strongly considered
Vaccine risk is high, termination is mandated.
Miscellaneous (Gynae)