EMQ — Extended Matching Question · Review
Question 761
Obstetric infection → Viral
Classification
Question
EEMQQuestion Header
Select the single most appropriate management.
Question Stem
A seronegative woman at 22 weeks received antiviral post-exposure prophylaxis after household chickenpox exposure and remained well. Six weeks later she has another significant exposure. Repeat assessment shows that seroconversion has not occurred. What is the most appropriate management?
Answer Bank
A
No further prophylaxis can be given during the same pregnancy
B
Prescribe a second course of oral antiviral prophylaxis from day 7 after the new exposure
C
Give varicella vaccine immediately
D
Arrange delivery before the incubation period ends
E
Perform amniocentesis immediately
F
Give intravenous aciclovir immediately
G
Refer directly for fetal MRI
H
Give neonatal VZIG
Correct Answer
B. Prescribe a second course of oral antiviral prophylaxis from day 7 after the new exposure
Explanation
If a susceptible pregnant woman has a further exposure and seroconversion has not occurred, the guideline permits another course of antiviral prophylaxis beginning 7 days after the new exposure. Previous PEP does not remove the need to reassess a subsequent significant exposure.
Option Validity
A) Further significant exposure may require repeat prophylaxis.
C) Varicella vaccine is not used during pregnancy.
D) Exposure alone is not an indication for delivery.
E) Amniocentesis is not indicated for exposure without maternal infection.
F) Intravenous aciclovir is treatment for severe chickenpox, not routine PEP.
G) Fetal MRI is not indicated following exposure alone.
H) Neonatal prophylaxis is unrelated to this mid-pregnancy exposure.
Further Reading
RCOG Green-top Guideline No. 13. Chickenpox in Pregnancy. Royal College of Obstetricians and Gynaecologists; January 2015, minor update 2024.