Screening/Diagnosis:  Pregnant women exposed to varicella-zoster infection in pregnancy are at risk for

 

Recommendations for pregnant women that report exposure to varicella infection

 

A.              If IgG seropositive they have previous immunity

 

B.              If  IgG negative they are susceptible and should have VZIG within  96 hours after exposure

·       Contact MFM at Duke to arrange acquisition of VZIG and subsequent administration

 

A.              In the first and second trimesters:

·       Counsel women that the risk of congenital infections is low (about 2%)

·       Ask the mother to observe for signs/systems of varicella pneumonia

·       Discuss high dose acyclovir with provider to shorten the duration of active lesions

·       Discuss need for ultrasound examinations with provider

 

B.              Near delivery

·       Inform pediatrics of maternal disease including timing of outbreak and last lesions

The Clinical Care Guidelines Development Committee of the Perinatal Improvement Board of Duke University Health System has developed a series of multi-disciplinary protocols to offer guidance to health care providers who are caring for pregnant women with high risk conditions.

 

These protocols are designed to assist health care providers in the management of a variety of problems that occur in pregnancy and the time of delivery. They should not be interpreted as standard of care, but instead represent only general guidelines for the care of pregnant women with high risk conditions.  We recognize that services offered by individual providers depend not only on their training, experience and institutional resources, but on the medical facts and circumstances of the specific care situation.

The protocols remain the intellectual property of the Duke University Health System.  They cannot be reproduced in whole or part without the expressed permission of the Health System.

 

These protocols are reviewed by the Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine, the Department of Pediatrics Division of Neonatology and the Department of Anesthesiology Division of Women’s Anesthesia.  Please contact Andra H. James (andra.james@duke.edu), Chair, Clinical Care Guidelines Development Committee of the Perinatal Improvement Board with ideas for additional protocols