EMQ — Extended Matching Question · Review
Question 757
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate peripartum management.
Question Stem
A woman at 38+2 weeks develops chickenpox with active vesicles. She is haemodynamically stable, fetal assessment is reassuring and there is no obstetric indication for immediate birth. Labour has not started.
Answer Bank
A
Elective caesarean birth immediately
B
Induce labour immediately to reduce fetal exposure
C
Continue pregnancy if safe and aim for at least 7 days from rash onset before planned delivery
D
Deliver within 24 hours before maternal viraemia increases
E
Delivery timing is irrelevant to neonatal varicella risk
F
Give VZIG to the mother and deliver immediately
G
Perform amniocentesis before deciding delivery timing
H
Deliver immediately because maternal antibodies cannot cross the placenta
Correct Answer
C. Continue pregnancy if safe and aim for at least 7 days from rash onset before planned delivery
Explanation
Delivery during active maternal viraemia may precipitate maternal haemorrhage or coagulopathy and carries substantial neonatal infection risk. When maternal and fetal conditions permit, planned delivery should normally be avoided for at least 7 days after rash onset to allow passive antibody transfer.
Option Validity
A) Immediate caesarean birth is not indicated solely because active chickenpox is present.
B) Delivery during the viraemic period may increase maternal and neonatal hazards.
D) The guideline advises avoiding planned delivery for at least 7 days after rash onset when safe.
E) Timing affects passive antibody transfer and neonatal infection risk.
F) VZIG is not treatment for established maternal chickenpox.
G) Amniocentesis does not determine immediate delivery timing in this setting.
H) Delaying delivery can permit transfer of protective maternal antibodies.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.