## Core Concept
Congenital rubella syndrome (CRS) occurs when a fetus is infected with the rubella virus during pregnancy, typically during the first trimester. This infection can lead to a range of serious birth defects. The core concept here involves understanding the effects of rubella virus on fetal development.

## Why the Correct Answer is Right
The correct answer relates to the specifics of congenital rubella syndrome. To address this question, we need to evaluate each option based on known facts about CRS. Common manifestations of CRS include hearing loss, cataracts, heart defects, and developmental issues. Without specific statements for A, B, C, and D, we'll proceed with a general understanding that the correct answer will contradict established knowledge on CRS.

## Why Each Wrong Option is Incorrect
- **Option A:** Without the specific details of option A, we can't directly address its accuracy. However, any statement consistent with established CRS manifestations (e.g., hearing loss, eye abnormalities) would be considered true.
- **Option B:** Similarly, if option B aligns with known CRS effects, such as congenital heart disease or intellectual disabilities, it would be incorrect to label it as the exception.
- **Option C:** This option would be incorrect if it describes a recognized feature of CRS.
- **Option D:** This is marked as the correct answer, implying it does not fit with the others as a true statement about CRS.

## Clinical Pearl / High-Yield Fact
A key point to remember is that congenital rubella syndrome can lead to a classic triad of findings: **cataracts**, **heart defects** (often patent ductus arteriosus), and **deafness**. The risk of severe congenital abnormalities is highest if infection occurs during the first 12 weeks of gestation.

## Correct Answer: D.