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Question 712
Obstetric infection → Viral
Classification
Question
SSBAQuestion Header
Alternative prophylaxis when antivirals cannot be used
Question Stem
A seronegative pregnant woman has significant exposure to chickenpox. Oral antiviral therapy is contraindicated. What is the most appropriate alternative post-exposure prophylaxis?
Options
A
Varicella vaccination
B
Intravenous aciclovir
C
Varicella-zoster immunoglobulin
D
Oral antibiotics
E
No intervention
Explanation
VZIG may be considered for post-exposure prophylaxis when oral antivirals are contraindicated or associated with adverse effects. VZIG is effective when given up to 10 days after contact; for continuous exposure, this is defined as 10 days from appearance of the rash in the index case. VZIG is prophylactic and has no therapeutic role once clinical chickenpox has developed.
Option Validity
A) live varicella vaccination is not used during pregnancy.
B) intravenous aciclovir is indicated for severe established maternal chickenpox.
D) antibiotics do not provide prophylaxis against VZV.
E) an alternative post-exposure prophylactic intervention is available.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 4.3.