EMQ — Extended Matching Question · Review
Question 759
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate postpartum advice.
Question Stem
A woman was found to be seronegative for VZV IgG during pregnancy. She remained uninfected and has now delivered. She wishes to breastfeed and asks about preventing chickenpox in a future pregnancy.
Answer Bank
A
Varicella vaccination is contraindicated while breastfeeding
B
Offer postpartum varicella immunisation and reassure her that breastfeeding is safe
C
Delay vaccination until breastfeeding has completely stopped
D
Give VZIG routinely after delivery instead of vaccination
E
No action is required because pregnancy itself produces immunity
F
Give live varicella vaccine during her next pregnancy
G
Advise permanent avoidance of future pregnancy
H
Repeat vaccination only after a future chickenpox exposure
Correct Answer
B. Offer postpartum varicella immunisation and reassure her that breastfeeding is safe
Explanation
Varicella vaccination before pregnancy or postpartum should be considered for women who are seronegative for VZV IgG. Women vaccinated postpartum can be reassured that it is safe to breastfeed.
Option Validity
A) Postpartum varicella vaccination is compatible with breastfeeding.
C) Breastfeeding does not need to cease before postpartum immunisation.
D) VZIG is used for selected post-exposure prophylaxis and does not replace vaccination of a susceptible postpartum woman.
E) Pregnancy does not confer VZV immunity.
F) Varicella vaccination should not be given during pregnancy.
G) Seronegativity is not an indication to avoid future pregnancy permanently.
H) Immunisation is preventive and need not await another exposure.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy.