Question of the Week

Question

Question :

Posted On : 01 Oct 2023

What is the effect on the fetus if the mother has chicken pox in the first trimester, should she continue the pregnancy?

Expert Answer :

Answer Discussion :

S

Shekhar Mehkarkar

0

Continue the pregnancy and get the treatment done for Varicella zoster..keep close follow up with the treating Obgy.

M

Mah Mobeen

0

yes. should continue pregnancy.

J

Joy Nkomeni

0

yes, she can continue with the pregnancy and seek treatment to avoid any congenital anomalies

Z

zeeshan majeed

0

yes but may fetus develop varicella syndrome and other congenital anamolise

D

Drnabila Khan

0

fetal varicella syndrome

Answer 1

In adults, varicella is associated with greater morbidity, namely pneumonia, hepatitis and encephalitis. Pregnant women who contract varicella are at risk of severe pneumonia. It should only be treated with aciclovir in severe courses of the disease. To date, there are no controlled studies concerning antiviral chemotherapy in preventing congenital varicella syndrome.

The risk for birth defects due to chicken pox infection in the first trimester of pregnancy is 0.5-1 percent. Mothers with varicella during the first or second trimester should be carefully monitored since an intrauterine infection may lead to congenital varicella syndrome {CVS}. Fetal ultrasound and magnetic resonance imaging {MRI} at 16–22 weeks gestational age or 5 weeks after infection can identify signs of CVS. If suspicious fetal abnormalities can be detected, laboratory investigations for VZV DNA in placental villi, fetal blood, or amniotic fluid and for VZV IgM in fetal blood are indicated. However, several studies have shown that the presence of VZV DNA alone does not necessarily correlate with fetal disease and, thus, cannot answer the question of how severely the fetus is affected. This and the low risk of CVS should be considered in counseling women with varicella in early pregnancy. Termination of pregnancy is only indicated if there are definitive signs of serious fetal abnormalities.

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