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How to manage chickenpox during pregnancy: case reports
Alexandre Gaymard1, Maxime Pichon1, Antonin Bal1
1Laboratoire de virologie, Hospices civils de Lyon, Institut des agents infectieux, Groupement hospitalier Nord, Lyon, France.
Annales De Biologie Clinique
|September 28, 2018
Summary
Pregnant women exposed to chickenpox (varicella) require prompt assessment. Serology testing and timely intervention with immunoglobulins or antivirals can prevent severe materno-fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Chickenpox (varicella) infection during pregnancy is uncommon but poses risks for congenital malformations and materno-fetal transmission.
- Management strategies are crucial to reduce adverse outcomes in pregnant women with unknown varicella immunity.
Observation:
- Three cases illustrate at-risk scenarios: a lethal varicella eruption in early pregnancy, varicella contact in early pregnancy managed with immunoglobulins, and late-pregnancy varicella contact treated with acyclovir.
- These cases highlight the importance of evaluating maternal immunological status against varicella.
Findings:
- Post-exposure serology is essential to determine a pregnant woman's immune status against varicella.
- Seronegative women require preventative measures like specific immunoglobulins or valacyclovir.
- Clinical varicella, particularly in the first trimester, necessitates immediate treatment with valacyclovir.
Implications:
- Prompt diagnosis and management of varicella exposure in pregnancy are vital for preventing congenital varicella syndrome and reducing perinatal morbidity and mortality.
- Establishing clear protocols for varicella screening and treatment in pregnant women can significantly improve materno-fetal outcomes.
- Antiviral therapy and immunoglobulin administration are key interventions in managing varicella during pregnancy.
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