Varicella Zoster Infection in Pregnancy

Question 1

Definition

Answer 1

Chickenpox is caused by the varicella zoster virus (VZV)

Question 2

Why is VZV dangerous in pregnancy

Answer 2

• More severe cases in the mother, such as varicella pneumonitis, hepatitis or encephalitis
• Fetal varicella syndrome
• Severe neonatal varicella infection (if infected around delivery)

Question 3

Immunity

Answer 3

Mothers that have previously had chickenpox are immune and safe.
- When in doubt IgG levels of VZV
- Non immune women offered vaccine before or after pregnancy
Prophylaxis during pregnancy = IV VARICELLA IMMUNOGLOBULINS = should be given within 10 days of exposure

Question 4

Treatment

Answer 4

Oral aciclovir if they present within 24 hours and are more than 20 weeks gestation

Question 5

Congenital varicella syndrome

Answer 5

1% of cases of chickenpox in pregnancy
Occurs in the first 28 weeks of gestation. Signs and symptoms:
- Fetal growth restriction
- Microcephaly, hydrocephalus, and learning disability
- Scars and significant skin changes located in specific dermatomes
- Limb hypoplasia (underdeveloped limbs)
- Cataracts and inflammation in the eye (chorioretinitis)