Chickenpox in Pregnancy
1. What is chickenpox and can I catch it during my pregnancy?
Chickenpox (varicella) is an illness caused by a virus called herpes zoster. It is a very infectious illness and most people get chickenpox in their childhood. Once you have had chickenpox, you cannot catch it a second time. During childhood, it is a mild infection that causes rashes. In adulthood however, chickenpox is more severe. Chickenpox rashes will first appear on the face and top half of the body. It can also spread over the entire body causing anything between 250 to 500 itchy and painful blisters.If you are pregnant and you have been exposed to a person with chickenpox and you have not been vaccinated, you are most likely to get chickenpox. Pregnant women who get chickenpox are at risk of serious complications such as pneumonia, with a 40% increase in the chances of mortality.
2. What are the symptoms of chickenpox?
The symptoms of chickenpox take between ten days to three weeks to appear. The first signs are high fever and feeling unwell. This is followed by the formation of watery blisters which can appear anywhere on the body. The blisters are usually very itchy. After a few days the blisters burst, crust over and then heal. This may take up to two weeks. Other symptoms include dehydration from severe vomiting or diarrhoea, headache, infected skin lesions, worsening of asthma or more serious complications such as pneumonia.
3. How does the chickenpox virus get transmitted?
The chickenpox virus is highly contagious and can spread from person to person by direct contact or through the air from an infected person coughing or sneezing. A person with chickenpox is contagious one to two days before the rashes appear and until all blisters have formed scabs. It takes anything from ten to 21 days after contact with an infected person for someone to develop chickenpox.
4. Can chickenpox affect my baby?
The risk of your baby being affected will depend on at what stage of pregnancy you were in at the time you contract the disease.If you get chickenpox while in the first or early second trimester of pregnancy, there is a small chance (0.4 – 2.0%) that the baby could be born with birth defects known as the ‘congenital varicella syndrome.’ Babies born with the ‘congenital varicella syndrome’ may be of low birth weight and have scarring of the skin and problems with arms, legs, brain and eyes.
If you get chickenpox between the 28th to 36th week of pregnancy, the virus stays in the baby’s body but will not cause any symptoms. However, it can become active again after birth and may cause shingles in the first few years of the child’s life.
If you get chickenpox at any time after the 36th week and till birth, the baby may become infected and could be born with chickenpox.
5. Can chickenpox harm me in my pregnancy?
Yes. It can cause chest infection (pneumonia), inflammation of the liver (hepatitis) and inflammation of the brain (encephalitis). Nevertheless, the chances of a woman dying from complications of the disease during pregnancy are very rare.
6. Will I be treated if I get chickenpox and are the medications safe for my unborn baby?
When you get chickenpox lesions you will be treated with an antiviral medication called aciclovir within 24 hours. This will reduce your fever and symptoms. Aciclovir is usually given if you are pregnant for more than 20 weeks. No medication during pregnancy is without its risks and these will be discussed with you. It is important to understand however that once you have chickenpox, there are no treatments that can prevent your unborn child from contracting the disease.
7. What should I do if I come across a person infected with chickenpox when I am pregnant?
If a pregnant woman comes in contact with a person who has already been infected by chickenpox for 15 minutes or more; either by being in the same room, through face-to-face contact or contact in a large open area, she is considered to be significantly exposed to the risk of contracting chickenpox.If you have had chickenpox at any point in your life before your pregnancy, you are immune and will not develop chickenpox during your pregnancy or later. Nonetheless, if you are uncertain about previous exposure, you have to consult your doctor to confirm the risk of exposure. He will then advise you to perform a blood test to determine the presence of the varicella antibodies in your body. If the doctor finds that you have not had previous exposure or varicella antibodies, he will advise you to take the Varicella Immunoglobulin (antibodies) within ten days of your exposure. This is a human blood product that strengthens the immune system for a short period of time.
8. What should I expect if I catch chickenpox before my child is born?
If your baby is born within seven days of your chickenpox rashes appearing, then the baby may get severe chickenpox. The baby will be treated with medications.
9. Can I breastfeed my new born?
It is safe to breastfeed your baby if you have or had chickenpox during pregnancy.
10. Is there a chickenpox vaccination?
If you didn’t get chickenpox earlier, you can be vaccinated against it when you are not pregnant. You will have to take two doses of the vaccine, which can be given at a six to eight-week interval. The chickenpox vaccination is effective in making nine out of ten women immune. The vaccination cannot be given in pregnancy and you should avoid getting pregnant for three months after the injection. If you find out that you are not immune to chickenpox during pregnancy, your doctor may discuss vaccination after the birth of your baby as the vaccine is safe for nursing mothers.
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This article was originally featured in Mummy’s Secret 3 – Your comprehensive guide to a healthy pregnancy.
Written by Dr Thaneemalai Jeganathan, Consultant, Obstetrician & Gynecologist, DEMC Specialist Hospital; MBBS (Thanjavur Medical College), M.Med (O&G) (UM)
Major (R) Dr. Thaneemalai Jeganathan is a Consultant Obstetrician & Gynaecologist with DEMC Specialist Hospital, Shah Alam, Selangor. He received his undergraduate medical education in India at the Thanjavur Medical College. He then went on to practice in various government hospitals before undertaking a specialist training in Obstetrics & Gynaecology in University Malaya, Kuala Lumpur and becoming a RCOG Certified Trainer on ‘Life Saving Skills in Obstetrics and the New Born Care Course’ in 2008. With over 20 years of experience in the medical field, Dr. Thanee has a wide obstetrics experience, ranging from normal deliveries to complicated pregnancies and extensive experience in gynaecological surgeries. In addition to his medical practice, Dr. Thanee also lectures and provides trainings to medical students and has a keen interest in Minimal Invasive Surgery, Urogynecology and Fetomaternal Medicine.
