Chicken pox

Chicken pox in pregnancy is rare (one case in 2000 pregnancies). Most people in developed countries have had chicken pox at some time during childhood and have developed immunity. Where there is doubt or where there is concern about recent contact by a pregnant woman with someone infected by the virus, a blood test may be performed to check for past (immunoglobulin G level) or recent (immunoglobulin XI level) infection with the virus. Where immunity is in doubt, contact should be avoided.

The virus is spread from person to person. The carrier is highly infectious 2 days before the rash appears until 1 week after.

Generally, if a woman develops chicken pox in the middle part of pregnancy, there is little risk to the fetus. However, infection in the first trimester, and particularly the first 8 weeks of pregnancy, may cause birth defects in a minority of babies. During this time, the fetus is developing rapidly and by the end of the first 8 weeks all the baby's organs are fully formed. Any attack during this period is thus more likely to result in a problem. There is a recognised syndrome, the 'varicella syndrome', which consists of limb shortening, scarring, possible brain development problems and eye defects.

Primary infection in the mother in late pregnancy is associated with infection in newborns that is usually mild, but if infection occurs within 5 days of delivery then it may be severe. Giving immune therapy (immunoglobulin) to an infected mother or an infected baby reduces the risk.

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