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Question 738
Obstetric infection → Viral
Classification
Question
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Features of fetal varicella syndrome
Question Stem
A woman developed chickenpox in early pregnancy. Which fetal or neonatal finding is characteristically associated with fetal varicella syndrome?
Options
A
Symmetrical limb overgrowth
B
Macrosomia with polyhydramnios
C
Isolated postaxial polydactyly
D
Dermatomal skin scarring with limb hypoplasia
E
Isolated macrosomia without structural abnormality
Explanation
Fetal varicella syndrome may include characteristic dermatomal skin scarring, limb hypoplasia, ocular abnormalities such as microphthalmia, chorioretinitis or cataracts, and neurological abnormalities including microcephaly and cortical atrophy. Dysfunction of bowel and bladder sphincters may also occur. The syndrome is thought to result from subsequent herpes zoster reactivation in utero rather than simply from the initial fetal infection.
Option Validity
A) limb hypoplasia rather than limb overgrowth is characteristic.
B) macrosomia with polyhydramnios is not a characteristic FVS pattern.
C) isolated postaxial polydactyly is not a defining feature of FVS.
E) isolated macrosomia is not characteristic of fetal varicella syndrome.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 6.1.