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Chickenpox in mid-trimester pregnancy: always innocent?
R Wheatley1, R E Morton, J Nicholson
1Central School Clinic, Blackpool, London, UK.
Developmental Medicine and Child Neurology
|May 1, 1996
Summary
Congenital varicella infection can cause severe fetal damage without typical skin lesions or limb shortening. Recent studies suggest maternal varicella poses a lower risk to fetuses than previously believed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Teratology
Background:
- Congenital varicella syndrome (CVS) is a rare condition resulting from maternal varicella-zoster virus (VZV) infection during pregnancy.
- Typical features of CVS include cicatricial skin lesions, limb hypoplasia, and central nervous system abnormalities.
- The spectrum of fetal VZV infection can vary, with some cases presenting atypically.
Purpose of the Study:
- To present an unusual case of congenital varicella infection with profound cerebral damage but lacking characteristic skin and limb anomalies.
- To compare this case with existing literature on fetal VZV infection.
- To re-evaluate the risks of maternal VZV infection to the fetus based on current evidence.
Main Methods:
- Case report presentation.
- Literature review and comparison with published series of congenital varicella infection.
- Analysis of recent prospective studies on maternal VZV infection risks.
Main Results:
- The presented case exhibited severe cerebral damage but lacked the expected cicatricial skin lesions and limb shortening.
- This combination of findings is uncommon in reported cases of congenital varicella.
- Recent prospective studies indicate a lower risk of fetal damage from maternal VZV infection than previously estimated.
Conclusions:
- Congenital varicella infection can manifest with atypical presentations, challenging diagnostic expectations.
- The absence of classic signs does not rule out significant fetal neurological sequelae.
- Updated risk assessments suggest maternal VZV infection during pregnancy may be less detrimental to the fetus than previously understood, necessitating careful interpretation of risks.