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[Rubella deafness. Audiometric, ophthalmologic, epidemiological aspects]
Insights
Maternal rubella during pregnancy can cause congenital deafness in children, often with hearing asymmetry and vision problems. Early diagnosis is crucial but frequently missed, impacting long-term development.
Area of Science:
- Pediatrics
- Ophthalmology
- Audiology
Context:
- Reviews 75 case reports of childhood deafness linked to maternal rubella during early pregnancy.
- Highlights common co-occurring conditions: auditory functional asymmetry, pigmented retinitis, cataracts, and developmental delays.
- Notes a high incidence of maternal rubella in women from outside French Metropolitan areas.
Purpose:
- To analyze the etiological factors and clinical manifestations of congenital deafness resulting from maternal rubella.
- To emphasize the diagnostic challenges and the impact of misdiagnosis in suspected rubella cases during pregnancy.
- To underscore the importance of recognizing specific clinical signs for accurate etiological diagnosis.
Summary:
- Congenital rubella infection leads to deafness in children, frequently presenting with interauricular auditory functional asymmetry (nearly 50% of cases).
- Pigmented retinitis, occurring alone or with cataracts, is another significant indicator, accounting for at least 7% of sensorineural deafness cases.
- Delayed development and dysmaturity at birth are persistent issues, compounded by diagnostic errors and inadequate family counseling regarding rubella in pregnancy.
Impact:
- Accurate diagnosis of rubella-induced deafness allows for better hearing aid adaptation, improving auditory outcomes.
- Recognizing pigmented retinitis aids in identifying rubella as the cause of deafness and potential visual impairment.
- Improved diagnostic accuracy and family communication are essential to mitigate the long-term developmental consequences of congenital rubella syndrome.
Abstract:
Case-reports of 75 children, with deafness due to an embropathy from maternal rubella during the first months of pregnancy, are reviewed. Emphasis is placed on the frequency of interauricular functional asymmetry, of pigmented retinitis alone or associated with a cataract, and of dysmaturity at birth and persistence of overall delayed development. Also stressed are the large proportion of women born outside the French Metropolitan area who contracted rubella during pregnancy, and the very high frequency of errors in interpreting clinical and biological signs in suspected rubella, leading to an impressive number of wrong suggestions with marked effects on the future. Following a detailed description of 15 of the 75 cases studied, the results obtained are analyzed. Nearly half of the cases presented an interauricular auditory functional asymmetry, which is therefore one of the elements of etiological diagnosis and which enables better adaptation of a hearing aid for rubella-induced deafness. The very high frequency of pigmented retinitis alone also constitutes and element of etiological diagnosis, and enabled at least 7 p. cent of overall cases of perception deafness to be assessed as resulting from a rubella cause. The pigmented retinitis is sometimes central and, contrary to classical notions, provokes visual dysfunction. Difficulty in applying a correct diagnosis during the initial episode, and the usual lack of information given to the family in case of rubella during pregnancy, are common features in the vast majority of cases.