## **Core Concept**
The rubella virus, also known as German measles, is a highly contagious viral infection that can cause serious birth defects if a pregnant woman contracts it, especially during the first trimester. However, the risk of congenital rubella syndrome (CRS) decreases as pregnancy progresses.

## **Why the Correct Answer is Right**
The management of a pregnant woman infected with rubella virus at 22 weeks of pregnancy primarily involves monitoring and supportive care. Since the infection occurred after the first trimester, the risk of severe congenital abnormalities is lower compared to infections occurring earlier in pregnancy. The approach typically includes regular prenatal monitoring for any signs of fetal distress or anomalies, and providing symptomatic relief for the mother's illness.

## **Why Each Wrong Option is Incorrect**
- **Option A:** There is no specific antiviral treatment for rubella virus infection, making antiviral therapy not applicable.
- **Option B:** While termination might be considered in cases of severe congenital anomalies detected early in pregnancy, at 22 weeks, the decision would be based on the presence of significant anomalies, not solely on the history of rubella infection.
- **Option C:** Immunoglobulins might be used for post-exposure prophylaxis in non-pregnant individuals or for certain high-risk exposures, but their role in managing an established infection during pregnancy is limited.

## **Clinical Pearl / High-Yield Fact**
A crucial point to remember is that rubella infection during the first 16 weeks of gestation, particularly the first trimester, carries a high risk of congenital rubella syndrome, which can lead to severe birth defects. Vaccination against rubella (as part of the MMR vaccine) is critical for preventing such infections in women of childbearing age.

## **Correct Answer:** D. **Supportive care and monitoring**.