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Question 716
Obstetric infection → Viral
Classification
Question
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Fetal surveillance after maternal chickenpox
Question Stem
A woman develops chickenpox at 13 weeks of gestation and recovers without maternal complications. What is the most appropriate fetal surveillance?
Options
A
Routine anomaly scan only at 20 weeks
B
Detailed fetal medicine ultrasound at 16–20 weeks or 5 weeks after infection
C
Detailed fetal medicine ultrasound immediately after the rash appears
D
Weekly ultrasound from diagnosis until delivery
E
Amniocentesis immediately after maternal diagnosis
Explanation
Women who develop chickenpox during pregnancy should be referred to a fetal medicine specialist for discussion and detailed ultrasound examination at 16–20 weeks or 5 weeks after infection. A time lag after primary maternal infection is important because fetal abnormalities may not be detectable on earlier imaging.
Option Validity
A) specific fetal medicine assessment is recommended following maternal chickenpox.
C) immediate ultrasound may be too early to identify fetal manifestations.
D) routine weekly scanning is not the recommended surveillance strategy.
E) amniocentesis requires counselling and should not be performed before maternal skin lesions have completely healed.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 6.2.