Varicella Zoster/Chickenpox Flashcards
Define VZV infection in pregnancy.
Primary infection with VZV.
Explain the aetiology of VZV in pregnancy.
Transmitted by physical contact, aerosol, vertical transmission
What are the risk factors for VZV in pregnancy?
No prior immunity, contact, immigration from tropical/subtropical areas.
Summarise the epidemiology of VZV in pregnancy.
3/1000 pregnancies.
What are the symptoms of VZV in pregnancy?
Fever
Malaise
Pruritic rash (vescicular then crusts over)
What are the signs of VZV in pregnancy?
Vescicular pleiomorphic rash
What investigations would you do for VZV in pregnancy?
Blood: VZV IgM in the acute phase, IgG to check immunity.
USS: Fetal antenatal anomaly scan (fetal varicella syndrome)
What is the management for VZV in pregnancy?
Non immune mother: VZVIG (reduces chance by 50% after exposure)
Established VZV: Aciclovir, if within 24h of rash onset.
Maternal infection near term: Avoid elective delivery for 5-7 days from the appearance of rash (placental transfer of maternal Ab over 5-7d)
Neonate: VZVIG if delivered within 7d of rash onset, before or after.
What are the complications associated with VZV in pregnancy? What is the prognosis of VZV in pregnancy?
Maternal pneumonia (10%, only in prengnat women!), hepatitis, encephalitis, death.
Fetal varicella syndrome: If maternal infection before 28wk, skin scar, eye defects, neuro defects, limb deformities.
Neonatal: VZV infection in the newborn (if maternal infection 1-4wk before delivery to 1wk after.