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Fetal varicella syndrome: quantified risk and prenatal assessment

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Facts & Figures #115 — Edit

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• Chickenpox during the first trimester does not appear to increase the risk of spontaneous miscarriage.
• Maternal varicella or seroconversion during the first 28 weeks carries a small risk of fetal varicella syndrome.
• In pooled prospective data, fetal varicella syndrome occurred in 13 of 1423 pregnancies affected before 20 weeks, an incidence of approximately 0.91%.
• The reported first-trimester risk of fetal varicella syndrome is approximately 0.55%.
• Fetal varicella syndrome has been reported following maternal infection as early as 3 weeks and as late as 28 weeks of gestation.
• For maternal infection between 20 and 28 weeks, cohort data included one affected fetus among approximately 180 pregnancies, but the evidence does not permit a reliable incidence estimate.
• Detailed fetal ultrasound should be arranged at 16–20 weeks of gestation or at least 5 weeks after maternal infection.
• The 5-week interval is important because ultrasound performed only 4 weeks after maternal infection has failed to demonstrate abnormalities subsequently identified.
• Ultrasound abnormalities can include limb deformity, microcephaly, hydrocephalus, soft-tissue calcification and fetal growth restriction; fetal MRI may add information when ultrasound demonstrates morphological abnormalities.
• Amniotic-fluid VZV PCR has a strong negative predictive value but a poor positive predictive value for fetal damage, and amniocentesis should not be performed until maternal skin lesions have completely healed.

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Fetal varicella syndrome: quantified risk and prenatal assessment

Facts & Figures #115 — Edit

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