EMQ — Extended Matching Question · Review
Question 752
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate post-exposure prophylaxis.
Question Stem
A 34-year-old woman at 25 weeks has significant chickenpox exposure and VZV IgG below the threshold for immunity. Oral aciclovir previously caused a severe adverse reaction and antiviral PEP is considered unsuitable. She presents 6 days after contact.
Answer Bank
A
No prophylaxis because more than 72 hours have elapsed
B
Intravenous aciclovir
C
Varicella vaccination
D
VZIG
E
Oral aciclovir despite the previous severe reaction
F
Immediate amniocentesis
G
Immediate delivery
H
Antibiotic prophylaxis
Correct Answer
D. VZIG
Explanation
When oral antiviral prophylaxis is contraindicated or associated with significant adverse effects, VZIG may be considered. It is effective when administered up to 10 days after contact.
Option Validity
A) VZIG remains effective when given up to 10 days after contact.
B) Intravenous aciclovir is indicated for severe established maternal chickenpox.
C) Varicella vaccine is not used as PEP during pregnancy.
E) A significant adverse reaction is a reason to consider VZIG instead.
F) Amniocentesis is not post-exposure prophylaxis.
G) Exposure alone is not an indication for delivery.
H) Antibiotics do not prevent VZV infection.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.