Chickenpox Exposure in Pregnancy

Question 1

what is chickenpox?

Answer 1

primary infection with varicella-zoster virus

Question 2

what is shingles?

Answer 2

shingles is caused by the reactivation of dormant virus in dorsal root ganglion

Question 3

what is fetal varicella syndrome?

Answer 3

• varicella or zoster developing in the fetus following maternal varicella infection during early pregnancy
• risk of 1% if infection gathered before 20 weeks gestation

Question 4

what risk does chickpox exposure present to mother?

Answer 4

pneumonitis (5x greater risk)

Question 5

what are the features of fetal-varicella syndrome (FVS)?

Answer 5

• skin scarring
• eye defects (microphthalmia)
• limb hypoplasia
• microcephaly
• learning disabilities

Question 6

what risk does chickpox exposure present to fetus?

Answer 6

• fetus-varicella syndrome
• shingles in infancy
• severe neonatal varicella

Question 7

what can be checked to determine maternal varicella status?

Answer 7

maternal blood should be checked for varicella antibodies

Question 8

what is the post-exposure prophylaxis in pregnant women </= 20 weeks gestation with NO varicella antibodies?

Answer 8

• varicella-zoster immunoglobulin (VZIG)
• effective up to 10 days post exposure

Question 9

what is the post-exposure prophylaxis in pregnant women >20 weeks gestation with NO varicella antibodies?

Answer 9

• varicella-zoster immunoglobulin or antivirals
• given days 7-14 after exposure

Question 10

how is chickenpox managed in pregnancy?

Answer 10

oral aciclovir - if >20 weeks and presents within 24 hours of onset of rash