EMQ — Extended Matching Question · Review
Question 758
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate neonatal management.
Question Stem
A woman develops chickenpox 4 days before spontaneous birth at term. Her baby is clinically well immediately after delivery. What is the most appropriate action regarding varicella prophylaxis for the neonate?
Answer Bank
A
No prophylaxis unless the baby develops vesicles
B
Test neonatal VZV IgG and wait for the result
C
Give varicella vaccine immediately
D
Give prophylaxis as soon as possible with VZIG with or without aciclovir; testing is not required first
E
Separate mother and baby permanently
F
Give maternal oral aciclovir only
G
Delay prophylaxis until day 7 of neonatal life
H
Give routine antibiotics
Correct Answer
D. Give prophylaxis as soon as possible with VZIG with or without aciclovir; testing is not required first
Explanation
Babies born when maternal chickenpox occurs from 7 days before to 7 days after delivery should receive prophylaxis as soon as possible with VZIG with or without aciclovir. There is no need to test first.
Option Validity
A) Birth within 7 days of maternal rash onset carries a high risk of severe neonatal chickenpox.
B) Testing is not required before prophylaxis in this high-risk peripartum interval.
C) Varicella vaccination is not the recommended neonatal prophylaxis in this situation.
E) Permanent separation is not the recommended management.
F) Maternal treatment does not substitute for neonatal prophylaxis.
G) Prophylaxis should be given as soon as possible.
H) Antibiotics do not provide VZV prophylaxis.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.