Varicella Zoster/Chickenpox Flashcards

1
Q

Define VZV infection in pregnancy.

A

Primary infection with VZV.

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2
Q

Explain the aetiology of VZV in pregnancy.

A

Transmitted by physical contact, aerosol, vertical transmission

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3
Q

What are the risk factors for VZV in pregnancy?

A

No prior immunity, contact, immigration from tropical/subtropical areas.

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4
Q

Summarise the epidemiology of VZV in pregnancy.

A

3/1000 pregnancies.

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5
Q

What are the symptoms of VZV in pregnancy?

A

Fever

Malaise

Pruritic rash (vescicular then crusts over)

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6
Q

What are the signs of VZV in pregnancy?

A

Vescicular pleiomorphic rash

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7
Q

What investigations would you do for VZV in pregnancy?

A

Blood: VZV IgM in the acute phase, IgG to check immunity.

USS: Fetal antenatal anomaly scan (fetal varicella syndrome)

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8
Q

What is the management for VZV in pregnancy?

A

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.

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9
Q

What are the complications associated with VZV in pregnancy? What is the prognosis of VZV in pregnancy?

A

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.

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