Chickenpox during pregnancy: what is dangerous, symptoms, treatment, prevention
The content of the article:
- Characteristics of the chickenpox virus
- The pathogenesis of chickenpox in pregnant women
- Clinical manifestations of chickenpox during pregnancy
-
Risks of chickenpox during pregnancy
- Chickenpox and early pregnancy
- Chickenpox during late pregnancy
- Diagnosis of chickenpox
-
Treatment of chickenpox in pregnant women
Symptomatic therapy
- Late pregnancy management with chickenpox
- Complications of chickenpox in pregnant women
- Prevention
- Video
Chickenpox during pregnancy is a dangerous condition for both a woman and an unborn child. This is a highly contagious childhood infection, which in adults occurs with pronounced symptoms of intoxication and a characteristic rash.
If you suspect chickenpox, you should consult a doctor
According to modern research, only 5–7% of women of reproductive age have not previously had chickenpox. This is due to the fact that upon contact with a person who sheds the chickenpox virus, the probability of becoming infected exceeds 95%.
The peak incidence occurs at the age of 2-10 years (active contact of children in kindergarten and school). Therefore, by the age of 20, the vast majority of the population already has immunity to this disease. On average, 5 cases of chickenpox and 2 cases of herpes zoster in a pregnant woman are recorded per 1000 births per year.
Is chickenpox dangerous for pregnant women? Definitely yes. During this period, the disease is difficult, there is a high probability of complications and adverse effects on the fetus.
Characteristics of the chickenpox virus
Varicella zoster (Varicellavirus) is a representative of the herpesvirus group. When first ingested, it causes the symptoms of chickenpox. After clinical recovery, Varicellavirus lives in an inactive state for a long time inside nerve cells.
The cause of the disease is herpesvirus Varicella zoster
Under the influence of certain factors, it can become active even after tens of years and lead to the development of shingles.
The pathogenesis of chickenpox in pregnant women
Chickenpox symptoms can only occur in women who have not had chickenpox before pregnancy or have not been vaccinated against it.
An increased risk of infection with Varicellavirus during pregnancy is:
- women with an older preschool child;
- primary school teachers;
- medical professionals (especially in pediatrics);
- workers of preschool institutions (nannies, educators).
From person to person, the pathogen of chickenpox is transmitted by drip or contact. Particles of the virus are present in the elements of the rash on the skin and mucous membranes. At the stage of crusts, the virus is no longer detected. Therefore, a person remains contagious from the onset of the rash to the formation of crusts.
Once on the mucous membranes, Varicellavirus quickly invades cells, integrates into its DNA, multiplies, accumulates and, breaking a cell, moves on to the next one. The active distribution period lasts up to 6 days.
From the moment the virus enters the bloodstream, the pregnant woman feels the first symptoms of intoxication. With the blood flow, the pathogen penetrates the skin and the nervous system, causing changes characteristic of chickenpox.
Clinical manifestations of chickenpox during pregnancy
From the moment of contact with a sick chickenpox until the first symptoms appear (incubation period), it takes about two weeks (5–21 days).
The disease is characterized by the staging of the development of skin rashes.
The symptoms of pathology are divided into two groups:
- intoxication;
- damage to the skin and mucous membranes.
Signs of intoxication syndrome:
- a sharp increase in body temperature (more than 38 ° C);
- severe weakness;
- drowsiness;
- loss of appetite;
- nausea, sometimes vomiting;
- upset stool.
The longer the pregnancy, the more severe the signs of infection.
Simultaneously with the rise in temperature (less often - during the first day), the first elements of the rash appear on the scalp and trunk. Chickenpox is characterized by staged development of changes on the skin.
Stages of the chickenpox rash:
| Rash element | Characteristic |
| Spot | Rounded, painless, unconsolidated redness of the skin caused by local expansion of capillaries |
| Papule | A tubercle that rises above the surface of the skin. Cause - serous edema of the skin |
| Vesicle | A superficial cavity element that rises above the surface of the skin and contains serous fluid inside. The vesicle is unicameral, the cover is thin. Looks like dew drops on the skin surrounded by a rim of redness |
| Pustule | The same vesicle, only the liquid inside is cloudy, and the tire is more compacted |
| Crust | A dense brown mass that forms from a secreted vesicle or pustule and covers the healing site |
On the body, after itself, a chickenpox rash can leave areas of depigmentation that quickly disappear. On the face, single atrophic scars (pockmarks) are possible.
Chickenpox is characterized by a wavy rash. Within 6 days, new elements of the rash appear. In severe cases, rashes are found on the palms, heels, conjunctiva, external genitals, mucous membranes of the mouth and throat. In one area of the skin, all stages of the rash will be present - false polymorphism. This whole process is accompanied by intense itching.
Risks of chickenpox during pregnancy
During pregnancy, there are two periods most dangerous for the fetus:
- I trimester;
- last 10 days before childbirth.
Chickenpox and early pregnancy
In the first 20 weeks of gestation, all organs and systems of the unborn child are laid. Infection through the placenta at this stage is observed in 15% of cases and is characterized by the development of embryopetopathy. In half of the cases, premature birth occurs.
Possible consequences for the newborn:
- changes in the skin - scarring, hypopigmentation, lack of epidermis, bullous eruptions;
- pathology of the central nervous system (CNS) - microcephaly, hypoplasia of certain brain structures;
- eye damage - microphthalmia, optic nerve atrophy, anisocoria, cataract, chorioretinitis;
- skeletal anomalies - underdevelopment of the upper or lower extremities, lack of fingers, clubfoot;
- intrauterine growth retardation;
- abnormalities in the development of the kidneys and gastrointestinal tract.
Chickenpox during late pregnancy
If the expectant mother gets sick with chickenpox no earlier than a week before giving birth, there is a high chance of having a baby with chickenpox symptoms.
Since the baby does not have innate immunity from the mother, the disease will be severe with a high probability of complications. Mortality in this case is 20-50%.
Children who have had chickenpox in utero can become ill with it again during their life and suffer shingles in the first year of life
Diagnosis of chickenpox
In order to establish a diagnosis of chickenpox, the doctor only needs to conduct a detailed survey and examination of the patient.
In some cases, a blood test for the presence of immunoglobulins is required
In controversial cases (atypical or abortive course), a blood test for the presence of immunoglobulins (IgM) to Varicellavirus or determination of the DNA of the virus in the fluid from the vesicles will help to diagnose.
Treatment of chickenpox in pregnant women
If you suspect chickenpox, a pregnant woman should seek medical help as soon as possible. Even in the case of a mild course, daily monitoring of the condition of the woman and the fetus is necessary.
Antiviral treatment with Acyclovir can be prescribed to a woman only after 20 weeks of pregnancy and with her written consent. In early pregnancy, the drug may have teratogenic effects on the fetus.
Symptomatic therapy
To reduce body temperature, it is recommended to use drugs based on Paracetamol. Ibuprofen causes premature closure of the ductus arteriosus and is not prescribed for chickenpox.
For symptomatic treatment, drugs containing paracetamol are prescribed
The rash can be treated with a solution of aniline dyes (Potassium Permanganate, Brilliant Green, Fukortsin). To prevent bacterial infection, it is necessary to change underwear and bedding every day, and avoid scratching the vesicles.
Calamine lotion can be used to relieve itching during pregnancy.
Late pregnancy management with chickenpox
To prevent infection of the fetus with chickenpox from the mother, on the eve of childbirth (if the rash appeared 1–2 weeks before the expected date of birth), the woman is hospitalized in the infectious department of the maternity hospital.
If rashes are present on the external genitalia, a planned cesarean section is recommended.
Childbirth is tried to be delayed as much as possible so that antibodies can pass from mother to child. Immediately after birth, the baby is injected with a specific immunoglobulin.
If the child does not have signs of intrauterine chickenpox infection, he is isolated from the mother for a period while there is a risk of infection. Mom remains infectious up to 5 days from the moment of the last pouring. Breastfeeding takes place with expressed milk.
Complications of chickenpox in pregnant women
The likelihood of developing complications increases in parallel with the gestational age. In the third trimester, they are most difficult.
Common complications include:
- viral pneumonia (20%);
- bacterial skin infection;
- encephalitis;
- hepatitis.
Prevention
All women planning a pregnancy who do not remember or are not sure that they had chickenpox in childhood should donate blood for the presence of immunoglobulins (IgG) to Varicella Zoster. In case of a negative result, six months before the planned conception, it is recommended to vaccinate against chickenpox.
In order not to get infected, pregnant women must follow safety rules: avoid contact with presumably sick, limit visits to children's groups.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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