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Question 721
Obstetric infection → Viral
Classification
Question
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Postpartum management of varicella susceptibility
Question Stem
A woman is found to be seronegative for VZV IgG during pregnancy. She remains well and delivers at term. Which advice about prevention of chickenpox in a future pregnancy is most appropriate?
Options
A
Varicella vaccination is contraindicated while breastfeeding
B
No intervention is needed because pregnancy confers lasting immunity
C
Offer postpartum varicella immunisation; breastfeeding is safe
D
Give VZIG routinely after delivery
E
Delay vaccination until breastfeeding has stopped
Explanation
Varicella vaccination before pregnancy or postpartum should be considered for women who are seronegative for VZV IgG. A woman vaccinated postpartum can be reassured that it is safe to breastfeed. Identifying susceptibility therefore provides an opportunity to reduce the risk of varicella in a subsequent pregnancy.
Option Validity
A) postpartum vaccination is compatible with breastfeeding.
B) pregnancy itself does not confer immunity to VZV.
D) VZIG is used for specified post-exposure prophylaxis, not routine postpartum immunisation.
E) breastfeeding does not require postponement of postpartum varicella vaccination.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 4.1 and Executive Summary.