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New Guidelines from the U.K. Regarding Chickenpox and Shingles

by Katrina Wharton | February 12, 2015 10:46 AM
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The Royal College of Obstetrics and Gynaecologists issued this fourth edition this past January and recommend pregnant omen be screened by the health care provider in early prenatal care by asking them about previous chickenpox or shingles infections. The physician should then advise the woman to contact the office right away if she is exposed to the virus.

The new guidelines also warn pregnant women to avoid anyone with either illness and to be referred to a specialist should a rash develop after exposure. While many women have antibodies in their system to protect them from the virus since they had chickenpox as a child, the illness is not necessarily as mild in pregnant women as in children. The virus causes complications in 3 of every 1000 pregnancies.

"Chickenpox is rare in pregnancy and many adults will have had the virus when they were younger and are therefore immune. However, chickenpox can be serious for your health during pregnancy and complications can arise. It is vital that pregnant women with symptoms of the virus should contact their GP as soon as possible and avoid contact with potentially susceptible individuals, such as other pregnant women and babies," says the co-author of the guidelines, Professor Patricia Crowley from University College Dublin.

Dr. Manish Gupta, co-author of the guidelines says pregnant women should not be overly worried about their babies, "Women may worry about passing the virus on to their baby. However, this is quite rare and depends on what stage of pregnancy the virus was transmitted."

Other advice from the guidelines include the caveat that there should be a minimum of 7 days between the appearance of a rash and the delivery of the baby, but also concedes, each birth should be looked at individually to make the best choice.

The RCOG also states that women should breastfeed their babies if they desire to do so and are well enough to do it.

The American College of Obstetricians and Gynecologists recommend women should make sure all their immunizations are up to date prior to conception if at all possible. This is especially true with varicella vaccine, since it cannot be administered to pregnant women and the illness can cause serious problems in pregnancy. Having chickenpox in pregnancy, particularly in the first few months, can cause birth defects and result in serious issues with the mother's health, including the risk of developing pneumonia.

If a pregnant woman has never received the varicella or chickenpox vaccine, she should be tested for antibodies to the illness. It requires only a simple blood test.

If you are pregnant, never had the illness and don't have antibodies, and you become exposed to the illness, contact your physician right away. While the warnings about getting chickenpox in pregnancy can sound dire, it is still important to talk to your doctor right away if exposed as a treatment is available. Varicella zoster immune globulin or VariZIG can be given within 10 days of the exposure to chickenpox or shingles, but sooner is better.

According to the Centers for Disease Control and Prevention, the consequences of chickenpox for pregnant women and their offspring are serious. The illness is highly contagious, and is spread from person to person through direct contact or through airborne transmission through sneezing or coughing. Remember, a person with chickenpox is contagious one or two days before the rash appears. If you are exposed to the illness, it will take 10 days to 3 weeks to break out with chickenpox. According to the CDC, 10 to 20 percent of pregnant women with chickenpox develop pneumonia, and should that happen the risk of death is as high as 40 percent.

A baby born to a mother who developed chickenpox during pregnancy has a small chance of developing congenital varicella syndrome. While the risk is slight, at between .4 and 2 percent, the syndrome is serious resulting in low birthweight, scarring of the skin and problems with the limbs, brain and eyes.

Ideally a woman should be vaccinated for chickenpox a month or earlier before trying to or becoming pregnant. If she has not received the vaccine before pregnancy, it is vital that her family members or those in the household get vaccinated.


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