Varicella infection in pregnancy has possibly devastating consequences for both women and their fetus. Chicken pox is transmitted by respiratory droplets and by direct personal contact with vesicle fluid or indirectly via fomites. The incubation period of chickenpox is 10–21 days. There is no difference in clinical presentation of chicken pox in pregnancy. The pregnant woman develops high fever that can last for up to 7 days. The diagnosis of varicella is usually made clinically. The transmission rate during maternal viremia has been estimated at approximately 25 %. The consequences for the infant depend on the time of maternal infection. Fetal involvement can be in three forms: (1) “varicella embryopathy,” (2) congenital varicella, and (3) neonatal disease. Prenatal diagnosis is by detailed ultrasound examination and detection of VZV DNA by PCR in amniotic fluid. Oral antiviral agents (acyclovir, valacyclovir, or famciclovir) have been shown to significantly reduce herpes-related symptoms as well as the duration, intensity, and prevalence of zoster-associated pain. If a pregnant woman is inadvertently vaccinated or becomes pregnant within 4 weeks after vaccination, she should be counseled about the theoretical basis of concern for the fetus; however, vaccination during pregnancy should not be considered a reason to terminate pregnancy. Varicella, the primary infection with varicella-zoster virus in pregnancy, may cause maternal mortality or serious morbidity. Mortality rates between 20 and 45 % were reported in the pre-antiviral era but have fallen to 3–14 % with antiviral therapy and improved intensive care.
Herpes Zoster Maternal Infection Varicella Vaccination Varicella Infection Monophosphate Form
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Arvin AM. Varicella-zoster virus. In: Fields B, editor. Virology. 3rd ed. New York: Raven; 1995. p. 2547–86.Google Scholar
Straus SE, Ostrove JM, Inchauspé G, et al. NIH conference. Varicella-zoster virus infections. Biology, natural history, treatment, and prevention. Ann Intern Med. 1988;108:221.CrossRefPubMedGoogle Scholar
Tunbridge AJ, Breuer J, Jeffery KJ. British Infection Society. Chickenpox in adults – clinical management. J Infect. 2008;57:95–102.CrossRefPubMedGoogle Scholar
Pattanasuttinont S. Maternal chickenpox in peripartum period: a case report and review. J Med Assoc Thai. 2008;91:110–65.PubMedGoogle Scholar
Sauerbrei A, Wutzler P. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 2: varicella-zoster virus infections. Med Microbiol Immunol. 2007;196:95–102.CrossRefPubMedGoogle Scholar
Department of Health. Report of confidential enquiries into maternal deaths in the United Kingdom 1985–87, 1988–90, 1991–93.1994–96. London: HMSO.Google Scholar
Cox SM, Cunningham FG, Luby J. Management of varicella pneumonia complicating pregnancy. Am J Perinatol. 1990;7(4):300–1.CrossRefPubMedGoogle Scholar
Harger JH, Ernest JM, Thurnau GR, Moawad A, Momirova V, Landon MB, et al. Risk factors and outcome of varicella-zoster virus pneumonia in pregnant women. J Infect Dis. 2002;185(4):422–7.CrossRefPubMedGoogle Scholar
Paryani SG, Arvin AM. Intrauterine infection with varicella-zoster virus after maternal varicella. N Engl J Med. 1986;314:1542–6.CrossRefPubMedGoogle Scholar
Enders G, Miller E, Cradock-Watson J, et al. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet. 1994;343:1548–51.CrossRefPubMedGoogle Scholar
Higa K, Dan K, Manabe H. Varicella-zoster virus infections during pregnancy: hypothesis concerning the mechanisms of congenital malformations. Obstet Gynecol. 1987;69:214–22.PubMedGoogle Scholar
Katz VL, Kuller JA, McMahon MJ, Warren MA, Wells SR. Varicella during pregnancy-maternal and fetal effects. West J Med. 1995;163:446–51.PubMedPubMedCentralGoogle Scholar
Skibsted L. Abnormal fetal ultrasound findings after maternal chickenpox infection. Ugeskr Laege. 2000;162(18):2546–9.Google Scholar