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GDM screening — MCCQE Part 1 MCQ

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HardPregnancy (Normal)GDM screeningMCCQE Part 1

A healthy pregnant woman is found to be rubella nonimmune at 10 weeks. There is no outbreak or exposure. She plans to breastfeed. Which immunization plan is most appropriate?

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Correct answer: B — Defer MMR during pregnancy and administer it in the immediate postpartum period before discharge

MMR is a live attenuated vaccine and is generally contraindicated during pregnancy because of theoretical fetal risk. In the absence of an outbreak-specific public-health recommendation, defer it and give one dose in the immediate postpartum period before hospital discharge. Breastfeeding is not a contraindication. This protects future pregnancies from congenital rubella syndrome; advise avoiding pregnancy for at least four weeks after vaccination. If MMR is inadvertently given during pregnancy, available evidence does not support recommending termination. Recent Rh immunoglobulin or other blood products can alter timing or follow-up, so the Canadian Immunization Guide's specific advice should be applied.

Reference: Canadian Immunization Guide, Rubella Vaccines: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-20-rubella-vaccine.html