EMQ — Extended Matching Question · Review
Question 753
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate treatment.
Question Stem
A 31-year-old woman at 30 weeks develops chickenpox. Her rash began 12 hours ago. She is systemically well, has no respiratory or neurological symptoms and has no evidence of severe disease.
Answer Bank
A
Oral aciclovir
B
VZIG as treatment
C
Intravenous aciclovir in intensive care
D
Varicella vaccination
E
Immediate induction of labour
F
No treatment because pregnancy contraindicates antivirals
G
Broad-spectrum intravenous antibiotics
H
Amniocentesis before treating the mother
Correct Answer
A. Oral aciclovir
Explanation
Oral aciclovir should be prescribed when chickenpox presents within 24 hours of rash onset at 20+0 weeks or later. Treatment before 20 weeks may also be considered.
Option Validity
B) VZIG has no therapeutic benefit once clinical chickenpox has developed.
C) Intravenous aciclovir is required for severe chickenpox; this woman has uncomplicated disease.
D) Vaccination is not treatment for active chickenpox.
E) Active uncomplicated chickenpox is not itself an indication for immediate delivery.
F) Aciclovir can be prescribed in pregnancy when clinically indicated.
G) Antibiotics do not treat uncomplicated VZV infection.
H) Maternal treatment should not be delayed for invasive fetal testing.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.