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Varicella in Pregnancy — SCE Infectious Diseases MCQ

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HardTravel Medicine & VaccinationVaricella in PregnancySCE Infectious Diseases

A previously non-immune pregnant patient at 20 weeks develops chickenpox and presents within 24 hours of rash onset. Which treatment should be offered after obstetric review?

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Correct answer: D — Start oral aciclovir within 24 hours and reassess urgently if severe disease develops

The best answer is “Start oral aciclovir within 24 hours and reassess urgently if severe disease develops”. UK guidance recommends prompt oral aciclovir after 20 weeks and allows earlier consideration; VZIG is post-exposure prophylaxis before disease, not treatment once the rash has appeared. Varicella in pregnancy requires prompt specialist risk assessment; oral aciclovir is considered after 20 weeks and may be considered earlier, ideally within 24 hours of rash onset.

Reference: UKHSA guidance on viral rash in pregnancy: https://www.gov.uk/government/publications/viral-rash-in-pregnancy