Varicella in pregnancy

Varicella-zoster virus may cause serious infection, particularly pneumonia, in adult women. Women of child-bearing age should be questioned about immunity to varicella preconceptually, and offered serological testing, and VARIVAX vaccine if indicated. All pregnant patients should be questioned about immunity to varicella during their first prenatal appointment. Susceptible patients should be counseled to avoid contact with individuals who have chickenpox. If exposure occurs, VZIG should be administered within 96 hours in an attempt to prevent maternal infection. Varicella embryopathy may occur as a result of maternal infection particularly in the first half of pregnancy with an incidence of 1% to 2%. Varicella of the newborn is a life-threatening illness that may occur when a newborn is delivered within 5 days of the onset of maternal illness or after postdelivery exposure to varicella. Susceptible neonates should receive VZIG. Acyclovir is active against the varicella-zoster virus, and treatment is indicated in seriously ill adults and neonates.