Chickenpox_Flashcards
Why is the VZV vaccine contraindicated in pregnancy?
The VZV vaccine is contraindicated in pregnancy because it is a live vaccine.
What is the management for non-immune women exposed to chickenpox before 20 weeks’ gestation?
If <20 weeks’ gestation, give VZIG immediately (only effective up to 10 days post-contact).
What is the management for non-immune women exposed to chickenpox after 20 weeks’ gestation?
If >20 weeks’ gestation, give either VZIG or antivirals (acyclovir or valacyclovir) 7-14 days after exposure.
What advice should be given to women exposed to chickenpox regarding contact with others?
Advise women to avoid contact with other pregnant women and neonates. Women are considered infectious for 21 days after exposure if they don’t receive VZIG, and for 28 days after exposure if they do receive VZIG.
What is the treatment for women ≥20 weeks’ gestation who present within 24 hours of rash onset?
Prescribe oral acyclovir (800mg 5/day for 7 days) if ≥20 weeks’ gestation and presenting within 24 hours of rash onset. Use IV acyclovir if severe chickenpox.
When should VZIG be given to pregnant women exposed to chickenpox?
VZIG should be given immediately if exposed before 20 weeks’ gestation and up to 10 days post-contact.
What advice should be given to pregnant women with chickenpox regarding contact with others?
Advise avoiding contact with other pregnant women and neonates until the lesions have crusted over (roughly 5 days after the onset of rash).
When should a pregnant woman with chickenpox be referred to a fetal medicine specialist?
Refer to a fetal medicine specialist at 16-20 weeks or 5 weeks after infection for detailed ultrasound assessment.
What precautions should be taken to avoid secondary bacterial infections of chickenpox lesions?
Good hygiene and symptomatic treatment should be maintained to avoid secondary bacterial infections of the lesions.
What is the recommendation for delivery if chickenpox infection occurs within the last 4 weeks of pregnancy?
If infection occurs within the last 4 weeks of pregnancy, elective delivery should be delayed until 7 days after the onset of the rash to allow for the passive transfer of antibodies to the fetus.
What postnatal care should be arranged for a neonate if the mother had chickenpox near the time of delivery?
Arrange a neonatal ophthalmic examination after birth, and if birth occurs within 7 days of the onset of the rash or the mother develops chickenpox within 7 days of delivery, the neonate should be given VZIG and monitored for signs of infection until 28 days after the onset of maternal infection.
What is the treatment for a neonate if neonatal chickenpox infection occurs?
Treat neonatal infection with acyclovir.
What preventive advice should be given to women who have not had chickenpox during pregnancy?
Advise women who have not had chickenpox to avoid contact with anyone with chickenpox or shingles during pregnancy.
