SBA — Single Best Answer · Review
Question 744
Obstetric infection → Viral
Classification
Question
SSBAQuestion Header
Recognition of severe maternal chickenpox
Question Stem
A pregnant woman with chickenpox is being managed at home. Which new clinical feature should prompt immediate referral to a hospital with intensive care access?
Options
A
Mild pruritus confined to existing lesions
B
Crusting of previously active lesions
C
Photophobia with increasing drowsiness
D
Improving appetite
E
Isolated mild fatigue without deterioration
Explanation
Neurological symptoms such as photophobia, seizures or drowsiness are features of potentially life-threatening chickenpox and require immediate hospital referral. Other warning features include respiratory symptoms, haemorrhagic rash or bleeding, and a dense rash with or without mucosal lesions. Hospital assessment should also be considered for women at increased risk of complicated disease even before such features develop.
Option Validity
A) mild pruritus alone is not one of the severe-disease warning features specified.
B) crusting represents progression towards the end of infectivity rather than a severe-disease warning sign.
D) improving appetite does not indicate severe chickenpox.
E) isolated mild fatigue without deterioration is not a specified indication for immediate intensive-care-capable referral.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 5.3.