Varicella in pregnancy

Question 1

What is Varicella in pregnancy (aetiology

Answer 1

Aetiology -respiratory transmission - 70% attachement rate in susceptible individuals
Incubate 10-21 days - infectious 48h BEFORE rash until vesciles crust (5days)
can give to baby transplacental, ascending vaginal, contact delivery

90% of women are immune

Question 2

Sx of Varicella in pregnancy (mother and baby)

Answer 2

Maternal - (still risk of encephelitis, pneumonia, sepsis)
Prodromal fever, malaise, myalgia
+ rash ( macular -> popular -> vesicular)
Delivering during varmic period is DANGEROus - DOC, bleed, hepatitis, transfer to baby

Congenital varcella - VZV antepartum - maternal transmission 12-20w
Eyes - chorioretinitis -> cataracts
MSK - limb hypopasia, cutaneous scarring
CNS - microcephaly
IUGR

loss of red reflex = Rubella and VZV

Neontal VZV -intra/post partum -maternal infection 7days before or after birth
Mild disease, skin lesions, pneumonia, visceral infection (can cause hepatitis)

Question 3

Ix of Varicella in pregnancy

Answer 3

Check maternal exposure during booking
if not - avoid significant contact ( 15mins same room or face to face)
If unsure - check VzV IgG before therapy

Question 4

Mx of Varicella in pregnancy

Answer 4

Antenatal/congenital–
VZIG within 10 days of exposure (before 20w)
Once sx have developed cannot give VZIg

Acyclovir- from 7-14d post exposre - after 20w

Hosp admission if RF present (smoke, lung disease, steroid use)- neonatal med specialist

Intrapartum - try and delay partum after 7 days after start of rash-. if not able - VZIG for both
no vaccines

Postpartum - neonatal ophlalmic exam after birth
infant monitored for infection
aciclovir if develop