Chickenpox during pregnancy: immunity, contact, and infection – a case report

Authors

  • Catarina Afonso Cruz Médica Interna de Medicina Geral e Familiar. USF Aqueduto, ACeS Grande Porto IV – Póvoa de Varzim. Vila do Conde, Portugal. Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS). Porto, Portugal.
  • Anabela Carvalho Rodrigues Médica Interna de Medicina Geral e Familiar. USF Aqueduto, ACeS Grande Porto IV – Póvoa de Varzim. Vila do Conde, Portugal.
  • Rita Sales Médica Assistente de Medicina Geral e Familiar. UCSP Sul (Santa Maria da Feira), ACeS Entre Douro e Vouga I – Feira e Arouca. Santa Maria da Feira, Portugal.

DOI:

https://doi.org/10.32385/rpmgf.v39i4.13560

Keywords:

Pregnancy, Chickenpox, Varicella zoster virus infection, Prenatal care, Chickenpox vaccine, case report

Abstract

Introduction: Varicella zoster virus primary infection during pregnancy is rare in Portugal as a result of the very high immunity rates of women of reproductive age. It is associated with higher risks of maternal complications, as well as significant fetal morbimortality, particularly if the mother acquires the infection during the first 20 weeks of gestation weeks or in the peripartum.

Case description: We report a case of a 31-year-old pregnant Russian patient, G2P1, with pregnancy managed by her family doctor and an obstetrician. At 27 weeks of gestation, she had a walk-in appointment with her family doctor reporting significant contact with varicella. At the time, she did not have symptoms or significant changes at the physical examination. The patient had no previous history of chickenpox or shingles, and no record of varicella-zoster virus immunization. She was referred to the obstetrics emergency department, where she was tested for varicella zoster virus serology. It was confirmed that the patient was not immune to the varicella-zoster virus and was offered immunoglobulin administration. She developed varicella at 29 weeks and two days of gestation, without associated maternal complications or ultrasound findings suggesting the development of fetal varicella syndrome. She delivered a healthy infant at 41 weeks and two days of gestation.

Comments: This case report aims to emphasize the importance of primary care physicians’ knowledge on the guidance of pregnant women who report significant varicella contact and/or develop varicella. In addition, this report highlights the importance of varicella immunity assessment at preconception counselling and care appointments to identify and manage non-immune women. 

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Author Biographies

  • Catarina Afonso Cruz, Médica Interna de Medicina Geral e Familiar. USF Aqueduto, ACeS Grande Porto IV – Póvoa de Varzim. Vila do Conde, Portugal. Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS). Porto, Portugal.

    Médica Interna de Formação Específica de Medicina Geral e Familiar; Doutoramento em Bioquímica, Faculdade de Ciências e Tecnologia da Universidade de Coimbra

  • Anabela Carvalho Rodrigues, Médica Interna de Medicina Geral e Familiar. USF Aqueduto, ACeS Grande Porto IV – Póvoa de Varzim. Vila do Conde, Portugal.

    Médica Interna de Formação Específica de Medicina Geral e Familiar

  • Rita Sales, Médica Assistente de Medicina Geral e Familiar. UCSP Sul (Santa Maria da Feira), ACeS Entre Douro e Vouga I – Feira e Arouca. Santa Maria da Feira, Portugal.

    Assistente em Medicina Geral e Familiar

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Published

2023-09-14

How to Cite

Chickenpox during pregnancy: immunity, contact, and infection – a case report. (2023). Portuguese Journal of Family Medicine and General Practice, 39(4), 345-50. https://doi.org/10.32385/rpmgf.v39i4.13560