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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Varicella in Pregnancy
5. Infection of fetus and neonate
Congenital infection typically occurs as a result of maternal infection from 13 to
20 weeks of gestation and has an incidence of about 2% after documented
maternal infection. Malformations typically include cutaneous scarring, limb
hypoplasia, and muscle atrophy. Other manifestations may include microcephaly,
intracranial calcifications, microphthalmia, and fetal growth restriction. Ultrasound
findings appear late and are not always present. PCR testing of amniotic fluid
may diagnose fetal infection. (Schleiss)
Neonatal infection may result in up to 25% of newborns if the mother was
infected within 5 days before delivery or 2 days thereafter. Skin lesions (Figure 2)
appear 5 to 10 days after birth and the mortality may approach 30%. If the
mother was infected 5 to 21 days prior to birth, skin lesions will appear during the
first 4 days of life, but the prognosis is good. Herpes zoster or shingles is not
associated with perinatal sequelae. (Whitley)
