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Question 714
Obstetric infection → Viral
Classification
Question
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Treatment of maternal chickenpox after 20 weeks
Question Stem
A woman at 26 weeks of gestation develops a typical chickenpox rash. She presents 12 hours after the rash first appeared and has no features of severe disease. What is the most appropriate specific treatment?
Options
A
Intravenous aciclovir
B
Varicella-zoster immunoglobulin
C
Varicella vaccination
D
Supportive treatment alone
E
Oral aciclovir
Explanation
Oral aciclovir should be prescribed for a pregnant woman with chickenpox who presents within 24 hours of rash onset at 20+0 weeks of gestation or beyond. Use before 20+0 weeks should also be considered. Intravenous aciclovir is used for severe disease. VZIG has no therapeutic benefit once chickenpox has developed.
Option Validity
A) intravenous therapy is indicated for severe chickenpox.
B) VZIG has no therapeutic role once the chickenpox rash has developed.
C) vaccination is not treatment for established chickenpox and is not given during pregnancy.
D) this woman meets the recommendation for oral antiviral treatment.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 5.2.