Treatment of Chickenpox in Pregnancy
Chickenpox (varicella) in pregnancy is a high-risk clinical scenario. Pregnant women are at significant risk of varicella pneumonitis and severe disease, and those close to term face additional risks of premature labour and neonatal infection.
Clinical Scenario
Pregnant women are at significant risk of varicella pneumonitis and severe disease. When presentation occurs close to term, the risk of premature labour and of neonatal infection makes specialist involvement essential.
Treatment Approach
Management centres on inpatient admission to an isolation facility with immediate access to specialist obstetric and paediatric services. Intravenous antiviral therapy is initiated, with transition to oral therapy as soon as the clinical situation allows.
The complete regimen — including drug selection, dosing, sequencing, and timing relative to delivery — is available in the full protocol.
References
DOI: 10.1016/j.jinf.2008.03.004
- Pregnant women are at significant risk of varicella pneumonitis and severe disease.
- If there is any concern about severity of the disease, referral to hospital should be made for consideration of parenteral therapy.
- Women who are close to term should be admitted to an isolation facility with access to specialist obstetric and paediatric services because of the significant risk of premature labour and of neonatal infection.
- Intravenous aciclovir should be administered, and if possible, delivery of the infant delayed until at least 5 days after the onset of infection.
- Switch to oral therapy as soon as possible.
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