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Question 724
Obstetric infection → Viral
Classification
Question
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High-risk maternal chickenpox
Question Stem
A woman at 30 weeks of gestation develops chickenpox. She has no dyspnoea, neurological symptoms, haemorrhagic rash or mucosal lesions and is haemodynamically stable. Which feature alone should prompt consideration of hospital assessment despite the absence of current complications?
Options
A
Nulliparity
B
Maternal age under 25 years
C
Second half of pregnancy
D
Previous uncomplicated vaginal birth
E
Normal oxygen saturation
Explanation
Hospital assessment should be considered for a pregnant woman at increased risk of severe or complicated chickenpox even when she has no concerning symptoms or signs. Recognised risk factors include smoking, chronic lung disease, immunosuppression including systemic corticosteroid use during the preceding 3 months, and being in the second half of pregnancy.
Option Validity
A) nulliparity is not listed as a risk factor for severe or complicated chickenpox.
B) maternal age under 25 years is not one of the specified high-risk features.
D) previous mode of birth does not determine the risk of severe maternal varicella.
E) a normal oxygen saturation does not remove the increased risk associated with being in the second half of pregnancy.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 5.3.