Chickenpox during Pregnancy

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Dr. Priyanka Kalra (Obstetrician and Gynaecologist)
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Chickenpox during Pregnancy

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Maintaining a healthy lifestyle and eating a balanced diet are very important during pregnancy. However, doing this does not always protect you and the little one inside from diseases and infections. One such disease that you need to be concerned about during this time is chickenpox. Is chicken pox dangerous during pregnancy?

What Is Chickenpox or Varicella?

Chickenpox is caused by a virus called Varicella zoster, and it can be highly contagious. It is not a dangerous disease, and lasts only for a short time in healthy kids. However, it can be dangerous for adults, including pregnant women, and can lead to serious complications.

Chickenpox and Pregnancy

During pregnancy, your body’s immune system gets suppressed to avoid foetal rejection. This lowers overall immunity, and makes you prone to infections. This means you are more susceptible to contagious diseases during pregnancy.

The possibility of serious complications from chickenpox is low, but it is important that you are aware of them. One such complication is getting pneumonia along with chickenpox when you are pregnant. Maternal pneumonia can result in foetal morbidity. Other complications include preterm labour, premature birth, and retarded growth of the baby.

As far as your baby is concerned, the risk depends on the time of contraction of the disease. If you develop chickenpox in early pregnancy between the eighth and twentieth week (first and second trimester), your baby is at a risk of congenital varicella syndrome, a rare birth defect. It might lead to underdeveloped legs and arms, scarring of the skin, incomplete development of the brain, and eye inflammation. The baby may suffer from mental and physical disabilities, along with seizures. The risk of stillbirth and miscarriage also increases. However, the risk of your baby developing this syndrome is very low.

If you contract the virus during the third trimester, your baby is most likely going to be fine. Your body starts producing antibodies after around five days of you contracting the disease. These antibodies reach the baby through the placenta.

If chickenpox develops a few days, almost five days before delivery, your baby might be born with neonatal varicella, a life-threatening infection.

Causes of Chickenpox

Chickenpox is caused by the Varicella zoster virus. It is a highly contagious disease, and it might affect your baby in your womb. If you already have taken vaccination against it, the chances of you contracting chickenpox are less.

It’s the weaker immune system of a pregnant woman that aggravates the risk of contracting this infection, even if you have taken the vaccination earlier in life.

Symptoms of Chickenpox in Pregnant Women

The symptoms will take anywhere from 10 days to 21 days to develop. You will get to see the symptoms after the second week of being exposed to the virus. Initially, you will experience a mild fever followed by itchy rashes. These rashes start as tiny red bumps, and later grow. Eventually, the rashes dry up, and the crusts fall out.

The first rash might appear on your face, abdomen, or chest and will eventually start appearing on the rest of your body. You will also experience fever, chills, and body ache.

Symptoms of Chickenpox in Pregnant Women

Women Who Are Most Likely to Get Varicella

Chickenpox as a disease is very contagious. If you have already had chickenpox earlier, then the chances of you contracting the virus are less. However, if you are not immune, and you have been in contact with a person carrying the virus, chances of you contracting the disease are high.

Complication of Chickenpox in Pregnancy

Chickenpox can cause a few complications to the baby as well as the mother. While the mother could develop pneumonia, the baby could be in danger of having its skin, limbs, brain, and other parts harmed.

Risks for Mothers

Getting the virus as an adult is riskier than getting it as a child. Also, the risks of varicella during pregnancy is higher if you suffer from lung conditions like emphysema or bronchitis.

  • You can develop a secondary condition known as varicella pneumonia, and this can be life-threatening. The risk of developing this condition is higher in the case of smokers, especially if you get the virus during your third trimester.
  • Meningitis that leads to the inflammation of brain could be one of the effects of varicella on pregnancy.
  • Hepatitis or inflammation of liver is yet another potential risk for the mother.

Risks for Unborn Baby

Complications affecting the unborn baby depend on the duration you have been pregnant. Let’s look at the risks involved:

  • If you contract the virus before 28 weeks of pregnancy, there is a small risk of your baby developing foetal varicella syndrome. This can damage the baby’s skin, limbs, brain, eyes, and bowel movements.
  • If you get the virus between 28 and 36 weeks of pregnancy, the virus is going to stay inside the baby’s body and but not do any harm. However, the virus can become active once the baby is born or during his first year, and cause shingles. In shingles, the chickenpox virus gets reactivated, causing red and painful rashes.
  • After 36 weeks, it is likely that the baby will get the virus and be born with chickenpox.

Risks for Newborn Baby

If you develop chickenpox around the time of the delivery, or if your baby is born within a week of the development of the rash, he may develop the disease as well. Your baby may contract chickenpox even if you get it within the first seven days of giving birth. Treatment for the baby needs to be started immediately.

Diagnosing Chicken Pox

You do not need medical tests to diagnose chickenpox. Given the fact that you will be going for regular health check-ups during pregnancy, your doctor will be able to look at you and say if you have chickenpox.

Mild fever followed by rashes and blisters are some obvious signs of chickenpox.

Diagnosing Chicken Pox

Chickenpox In Pregnancy Treatment & Management

The treatment depends on the severity of the infection. Early diagnosis is important for a speedy treatment. Your doctor might prescribe you OTC anti-viral medications to bring the severity of the ailment down. This will also reduce the complications.

If infected with chickenpox at the time of delivery, the doctor will give your baby an immunoglobulin medicine after his birth to reduce the severity of the infection. If your child is born with the chickenpox virus, remedial action in the form of antiviral drugs is taken.

If you are planning to conceive, you can consider getting a chickenpox prevention vaccination. This vaccination is safe for adults. However, you will need to wait for at least three months after the second dose of this vaccine before trying to conceive.

Sometimes, you may be exposed to chickenpox during pregnancy. In such cases, call your doctor who might prescribe an immunoglobulin injection. This contains antibodies for the varicella virus. If it is injected within ten days of exposure, the chances of you contracting the virus as well as the severity get reduced. However, whether this protects the baby inside is yet to be known, as congenital varicella syndrome is rare.

Is It Safe to Take Chickenpox Vaccine During Pregnancy?

No. As already mentioned above, it is recommended that you wait for three months after taking the vaccine before trying to conceive. Do not take the vaccine while you are pregnant, and wait to deliver instead. Get the first dose right after you deliver your baby, and the second dose six to eight weeks later. This way, you do not have to worry about the infection during your next pregnancy.

What Are the Chances of Getting Chickenpox?

Here are some factors that might make you vulnerable to the infection during pregnancy:

  • If you are not immune and you come in contact with an infected person, you can get the infection.
  • You can get the infection from a person having shingles, if you have never had chickenpox before.

Prevention

Make sure that you do not come near anyone who has chickenpox or is carrying the virus. This includes individuals who have come in contact with persons with chickenpox in the past three weeks. Avoid anyone who has flu-like symptoms as rashes develop later.

Avoid people who have shingles. Shingles affect people who have already had chickenpox in the past. The varicella virus gets reactivated and causes itchy and painful rashes on the skin. Try and get everybody above the age of 12 months in your family vaccinated.

Possibility of Developing Shingles

Shingles do not affect everyone. It develops in people with a weakened immune system like older adults. The risk of your developing shingles is minuscule, but even if you do, you do not need to worry about your baby. Shingles is harmless for your unborn baby. However, it can be harmful for your newborn. Exposure to shingles can cause chickenpox in your newborn baby.

Chickenpox is a highly contagious disease and can cause health complications in pregnant women. Though the disease isn’t fatal, pregnancy can aggravate the extent of damage caused. The best alternative is to either get a vaccine three-months prior to conceiving a child or immediately after delivery. For those who are already pregnant, it is crucial to remain vigilant and stay away from people showing the symptoms of chickenpox.

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