EMQ — Extended Matching Question · Review
Question 754
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate immediate management.
Question Stem
A 29-year-old woman at 32 weeks with chickenpox develops dyspnoea, increasing drowsiness and a dense vesicular rash involving the oral mucosa. She is tachypnoeic and clinically deteriorating.
Answer Bank
A
Continue home observation
B
Oral antihistamine alone
C
VZIG as definitive treatment
D
Delay referral until chest radiography confirms pneumonia
E
Immediate hospital referral and intravenous aciclovir
F
Routine outpatient review in 48 hours
G
Varicella vaccination
H
Oral antibiotics alone
Correct Answer
E. Immediate hospital referral and intravenous aciclovir
Explanation
Respiratory symptoms, neurological symptoms and a dense rash with mucosal lesions are warning features of severe chickenpox. Such women require immediate hospital referral, and all pregnant women with severe chickenpox should receive intravenous aciclovir.
Option Validity
A) Respiratory and neurological deterioration are features of potentially life-threatening chickenpox.
B) Symptomatic treatment alone is inadequate for severe disease.
C) VZIG has no therapeutic benefit after chickenpox has developed.
D) Investigation should not delay referral and treatment of severe disease.
F) Severe disease requires immediate hospital management.
G) Vaccination does not treat established chickenpox.
H) Antibiotics do not replace antiviral therapy for severe varicella.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.