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Question 719
Obstetric infection → Viral
Classification
Question
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Fetal risk following maternal chickenpox
Question Stem
A woman develops confirmed chickenpox at 17 weeks of gestation. During counselling she asks about fetal consequences. Which statement is most appropriate?
Options
A
First-trimester maternal chickenpox substantially increases spontaneous miscarriage
B
Fetal varicella syndrome occurs only following third-trimester infection
C
Maternal infection before 20 weeks inevitably causes fetal infection
D
Normal maternal recovery excludes subsequent fetal complications
E
Maternal infection or seroconversion in the first 28 weeks carries a small risk of fetal varicella syndrome
Explanation
Maternal varicella or seroconversion during the first 28 weeks of pregnancy carries a small risk of fetal varicella syndrome, and the woman should be informed of the implications. Fetal damage is not inevitable. The risk of spontaneous miscarriage does not appear to be increased when chickenpox occurs in the first trimester.
Option Validity
A) the risk of spontaneous miscarriage does not appear to be increased following first-trimester chickenpox.
B) fetal varicella syndrome is associated with maternal infection earlier in pregnancy, not exclusively in the third trimester.
C) fetal infection and fetal damage are not inevitable.
D) uncomplicated maternal recovery does not itself exclude fetal consequences.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 6.1.