Peripartum varicella infection in pregnancy: intrapartum, postpartum and recurrent risk presentations

Varicella infection during pregnancy has become increasingly uncommon in the postvaccination era; however, when it occurs, it presents distinct maternal and neonatal challenges that vary according to the timing of infection. This case series describes three women with varicella encountered during the intrapartum and postpartum periods, as well as a subsequent pregnancy following a prior neonatal death attributed to varicella. Each case illustrates a different clinical scenario requiring tailored maternal and neonatal management. Early recognition, timely initiation of antiviral therapy, appropriate use of neonatal immunoprophylaxis and pragmatic infection control measures resulted in favourable outcomes in all cases. These cases highlight persisting preventive gaps in antenatal care and underscore the importance of assessing immunity status and offering postpartum vaccination to susceptible women.