Act fast to treat varicella in pregnancy: 96-hour window.(Obstetrics)

ASHEVILLE, N.C. -- Only about 10% of chickenpox cases occur in adults, but when a pregnant patient is exposed to the virus, quick action is necessary, Dr. Joseph M. Ernest III said at the annual Southern Obstetric and Gynecologic Seminar.

There is a 96-hour window in which varicella zoster immune globulin (VZIG) can be given to reduce the severity of infection in a pregnant patient who is not immune to the virus, explained Dr. Ernest, professor of obstetrics, gynecology, and maternal-fetal medicine at Wake Forest University, Winston-Salem, N.C.

First, ask the patient if she has had chickenpox. Recollection of the disease is specific and adequate for determining immune status, he said.

Exposure poses no danger to a woman, or her fetus if she has a history of chickenpox. However, if the patient has no recollection, or is certain she hasn't had the virus, varicella zoster antibody titers must be measured. Any level of titers means the patient is immune.

Absence of titers means she is susceptible, and the time of exposure must be determined.

"Your role is to try and reduce the chance that chickenpox will impact her and/or the fetus," Dr. Ernest said.

Treat with VZIG within the 96-hour window. This won't necessarily prevent infection, but it may reduce severity of maternal infection.