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Chicken pox in pregnancy poses a threat to both the pregnant woman and the fetus. The most serious complication of a pregnant woman with smallpox is pneumonia, with a mortality rate of 2 percent. A child may develop congenital chickenpox syndrome. What other risks does chickenpox in pregnancy bring for the mother and the fetus? Can pregnant women get vaccinated against chickenpox?

Chickenpox in pregnancyis fortunately extremely rare - it is estimated that the percentage of pregnant women who have been infected and become resistant to the smallpox virus is 95 percent. This is good news, as chickenpox during pregnancy can cause serious complications and he alth problems for both the baby and the mother.

Chickenpox during pregnancy may be affected by those mothers-to-be who did not suffer from this disease in childhood, were not vaccinated and already have small children. In Poland, there is an obligation to vaccinate children who stay in nurseries or children's clubs against smallpox, vaccination against smallpox is also recommended for women who are planning to become pregnant and have not been ill before.

Despite this, cases of disease still occur - however, no more than 3 out of 1000 pregnant women suffer from chickenpox. This disease in pregnant women is much more severe than in other adults. Smallpox infection in the fetus can lead to serious complications, including death.

The fetus can get infected with the chickenpox virus only from a sick mother, if the mother is he althy, the child is sure too. Therefore, infection will not occur if a pregnant woman has childhood chickenpox or is vaccinated and her older child is ill.

Smallpox in pregnancy: the course of the disease

The virus that causes the smallpoxVaricella zoster virus(VZV) a pregnant woman can be infected by airborne droplets. The virus incubation period is up to 21 days, usually around 2 weeks. Smallpox manifests as an itchy rash that may be preceded by fever, headache, abdominal pain, and weakness - these symptoms may appear two days before the first eruptions.

The rash appears in several flare-ups over the next several days. It usually appears first on the face, hairy skinhead and torso, then on the limbs. The changes are of a different nature, from spots to lumps, vesicles, pustules, and then scabs. A pregnant woman infected with smallpox can infect others two days before the appearance of the rash until the blisters dry.

Smallpox in pregnancy: Treatment of smallpox in pregnancy

A mother-to-be, who did not suffer from smallpox in her childhood or is not vaccinated with it, and suspects that she may have been infected, for example, by a sick child, should contact a doctor as soon as possible. The risk of falling ill is greatest when the household is ill, or the direct contact "face to face" with the sick person lasted longer than 5 minutes.

The doctor decides what to do next, usually based on the data collected during the interview. Most often, expectant mothers with smallpox are given VZIG (varicella zoster immune globulin) immunoglobulin against Varicella virus within 96 hours of presumed exposure to the infection to alleviate symptoms and prevent maternal complications. However, this immunoglobulin does not protect the fetus.

Pregnant women who have symptoms of chickenpox are given the antiviral drug acyclovir, which alleviates the course and symptoms of the disease.

In the event of dyspnea, hemorrhagic rash or neurological symptoms, hospitalization is required.

Symptomatic treatment of smallpox in pregnant women consists in providing maximum comfort and using medications to alleviate symptoms. Paracetamol is the antipyretic and analgesic of first choice in pregnant women. In order to relieve itching, powders and mashings should not be used as they increase the risk of bacterial skin infections. However, it is possible to apply antipruritic preparations topically.

Smallpox in pregnancy: complications in the mother

The course of chickenpox in pregnant women is much more severe than in other adults. It also threatens with a series of complications, and even the death of the mother.

The most common complications of smallpox in pregnant women include:

  • Smallpox pneumonia
  • hepatitis
  • encephalitis
  • secondary bacterial infection of skin eruptions
  • meningitis
  • Guillain-Barry syndrome
  • transverse myelitis
  • palsy of cranial nerves
  • eye retinitis

It is estimated that pneumonia is a complication of smallpox in at least 10% of respondents. pregnant women suffering from it - its symptoms are mainly dyspnoea, especially exercise dyspnoea, as well as dry cough and fever.

Smallpox in pregnancy: complications in the baby

Smallpox inpregnancy also carries a number of complications for the fetus. Getting sick in the first trimester is associated with a greater risk of miscarriage, fetal death, and even congenital chickenpox.

If the mother becomes ill after 20 weeks of pregnancy, it may lead to herpes zoster in the baby in the first years of life, which is related to the primary intra-fetal infection. Infection of the mother a few days before and several days after delivery can cause severe generalized VZV infection in the newborn, which may even lead to the death of the newborn.

Therefore, the condition of the fetus must be obligatorily monitored. The basic tool is ultrasound examination at 18 and 28 weeks, during which the doctor checks whether the fetus has symptoms typical of congenital chickenpox. Fetal infection can also be diagnosed by serological tests of cord blood collected during one of the invasive prenatal tests - cordocentesis.

What does chickenpox look like? Rash with smallpox [PHOTOS]

See the gallery of 7 photos

Congenital pox syndrome symptoms

The most common symptoms of congenital chickenpox include:

  • microcephaly
  • atrophic skin changes
  • underdevelopment of the cerebellum
  • hydrocephalus
  • brain calcification
  • optic nerve atrophy
  • microphthalmia (i.e. small eyes)
  • retinitis
  • anisocoria (i.e. uneven pupil width)
  • cataract
  • inhibition of sensorimotor development
  • underdevelopment or deformity of limbs
  • dysfunction of the anal sphincter and bladder sphincter
  • skin scarring

It has been shown that children of mothers who showed signs of VZV infection in the perinatal period, but who did not develop congenital abnormalities, developed similarly to children with unburdened history.

Shingles in pregnancy: is it as serious as chickenpox?

Shingles is caused by the same virus as smallpox, but it affects people who have had smallpox. After having had chickenpox, the virus remains dormant in the ganglia. In situations of decreased immunity, the infection is reactivated and skin lesions appear, limited to a specific dermatome, i.e. the area of ​​the skin innervated by this one spinal nerve. This does not harm the fetus as antibodies already exist in both the mother and the fetus.

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