Medical and Surgical Complications in Pregnancy
A Pregnant lady acquires chicken pox 3 days prior to delivery. She delivers by normal vaginal route. Which of the following statements is true? (AIIMS May 2011)
|A||Both mother and baby are safe|
|B||Give antiviral treatment to mother intra partum|
|C||Give antiviral treatment to baby|
|D||Baby will develop neonatal varicella syndrome|
Baby will develop neonatal varicella syndrome
1. Administration of varicella-zoster immunoglobulin (VZIG) prevents or attenuates varicella infection in exposed susceptible individuals if given within 96 hours of viral exposure.
2. VZIG is recommended by the for immunocompromised susceptible adults who are exposed to varicella, and it should be strongly considered for all susceptible pregnant women (not when the women has already developed the infection)
a. An attenuated live-virus vaccine (Varivax) was approved for use in 1995
b. The vaccine is not recommended for pregnant women.
c. Maternal varicella during the first half of pregnancy may cause congenital malformations by transplacental infection.
d. Some of these include chorioretinitis, cerebral cortical atrophy, hydronephrosis, and cutaneous and bony leg defects.
4. There is no clinical evidence of congenital varicella infection after 20 weeks of gestation.
5. Fetal exposure to the virus just before or during delivery, and therefore before maternal antibody has been formed, poses a serious threat to newborns.
6. The incubation period for varicella infection is short, usually less than 2 weeks. In some instances, neonates develop disseminated visceral and central nervous system disease, which is commonly fatal.
7. For this reason, VZIG should be administered to neonates whenever the onset of maternal disease is within about 5 days before or after delivery