Chicken pox in pregnancy

Question 1

Transmission of chicken pox

Answer 1

Respiratory droplets
Direct personal contact with vesicle fluids
Indirect contact with formites
Incubation 1-3 weeks, infectious 48hrs prior to rash

If maternal infection occurs 1-4 / 52 before delivery up to 50% babies are infected and up to 23% will develop clinical varicella.

Question 2

Incidence in pregnancy of chicken pox

Answer 2

3:1000

Women from tropical/ subtropical are more likely not to be immune

75% death are in adults ( 25 people/ year)

Question 3

Mortality from chicken pox

Answer 3

3-14%

Question 4

Incidence of Pneumonia from chicken pox

Answer 4

10-14% of pregnant women

Question 5

Which symptoms show severe chicken pox infection?

Answer 5

• Respiratory symptoms
• Neurological symptoms such as photophobia, seizures or drowsiness
• Haemorrhagic rash or bleeding, or a dense rash with or without mucosal lesions
  -If the woman smokes cigarettes, has chronic lung disease, is immunosuppressed (including those who have taken systemic corticosteroids in the preceding
  3 months) or is in the second half of pregnancy, a hospital assessment should be considered even in the absence of complications.

Question 6

Acyclovir dose for tx of chicken pox

Answer 6

800 mg 5 times/ day for 7/7

Avoid in first trimester, but can be considered before 20/40

Question 7

Route of infection

Answer 7

• Transplacental
• Ascending
• Direct contact after birth