**Question:** Mother has been infected with rubella, all the following foetal congenital malformation can occur except: a) VSD, b) ASD, c) PDA, d) PS

**Core Concept:** Rubella, also known as German Measles, is a viral infection caused by the Rubella virus. Congenital rubella syndrome occurs when a pregnant woman contracts rubella and it crosses the placenta to infect the fetus. This can lead to a range of congenital malformations in the baby.

**Why the Correct Answer is Right:** Among the given options, pulmonic stenosis (PS) is not mentioned as a consequence of congenital rubella. This is because PS is a congenital heart defect characterized by narrowing of the pulmonary valve, whereas the other options (VSD, ASD, PDA) are types of congenital heart defects caused by rubella.

**Why Each Wrong Option is Incorrect:**

a) Ventricular septal defect (VSD): VSD is a type of congenital heart defect characterized by a hole in the wall separating the two ventricles. Congenital rubella can lead to VSDs due to the virus affecting the development of the heart during pregnancy.

b) Atrial septal defect (ASD): ASD is another type of congenital heart defect characterized by a hole in the wall separating the two atria. Similar to VSD, rubella can cause ASD due to its impact on heart development.

c) Pulmonary artery ductus arteriosus (PDA): PDA is a congenital heart defect characterized by an opening between the pulmonary artery and the aorta. Rubella can lead to PDA due to its impact on the development of the cardiovascular system.

d) Pulmonary stenosis (PS): As explained above, PS is not mentioned as a consequence of congenital rubella. This option is incorrect because children born with PS do not have a history of rubella infection in their mothers.

**Clinical Pearl:** It is crucial for healthcare professionals, especially obstetricians, to educate pregnant women about rubella vaccination to prevent congenital rubella syndrome and its associated congenital heart defects, such as VSD, ASD, and PDA. Early diagnosis and management of congenital rubella syndrome can significantly reduce morbidity and mortality in affected infants.