Chickenpox and hemiplegia in pregnancy

Chickenpox vs. hemiplegia

Both chickenpox and hemiplegia are caused by the Varicella Zoster Virus (VZV). Hemiplegia differs from smallpox in that it is a reactivation of a pre-existing infection. In addition, the infectiousness of chickenpox is much higher than that of hemiplegia. Both of these diseases usually present with a vesicular rash and pruritus. In the case of chickenpox, generalized symptoms appear more often.

Symptoms of chickenpox

The primary symptom of smallpox is a characteristic rash distributed over the entire body. It first manifests itself in the form of spots and papules, and then develops into pustules and scabs. Most often the scabs fall off after a few days and leave no permanent scars. The skin lesions may be accompanied by a fever of up to 39 degrees and malaise and itching.

Symptoms of hemiplegia

A very characteristic symptom for hemiplegia is the appearance of skin lesions on only one side of the body. The blisters may be accompanied by itching and pain, which sometimes persists even after the rash has subsided. It is a postherpetic neuralgia. Most often, hemiplegia lesions appear on the torso, but they can also occur on the limbs or head.

Treatment of hemiplegia and smallpox during pregnancy

If a pregnant woman has been in contact with someone with smallpox or shingles, VZIG immunoglobulin is recommended. This drug should be administered up to 96 hours after contact. If the mother-to-be has contracted chickenpox, the treatment of choice is acyclovir applied for 7 days. This management is aimed at minimizing the transmission of the virus across the placenta and reducing maternal-fetal mortality. Acyclovir is administered by the oral route. In addition,  painkillers, antipruritic drugs and antipyretics are used.

Complications of smallpox and hemiplegia in pregnancy

• U WOMEN

The course of chickenpox in adults can be more severe than it is in children. It can lead to complications such as pneumonia and neurological complications. Secondary bacterial infections of skin lesions are also common.

The most common complication of hemiplegia in pregnancy is postherpetic neuralgia (PHN), which develops in one in five pregnant women. Pain at the site of the rash may persist for several months.

• AT THE CHILD’S HOME

If you contract chickenpox or hemiplegia during pregnancy, you may develop complications such as congenital chickenpox. The risk is about 2%. Symptoms of congenital chickenpox include skin scarring, limb deformities, eye and nervous system defects. In addition, generalized edema or intrauterine growth restriction of the fetus can occur.

VZV infection in the second half of pregnancy increases a child’s risk of contracting hemiplegia in the first years of life. This is because the primary intrafetal infection has already occurred. Perinatal infections that can result in the death of the newborn in extreme cases are also particularly dangerous.

If a pregnant woman contracts hemiplegia, the risk of transmitting the infection to the developing fetus is much lower and the possible complications less severe.

Smallpox vaccination

Smallpox vaccination belongs to live vaccines. Such vaccines are  contraindicated for pregnant women. On the other hand, women planning a pregnancy who have not contracted smallpox in the past should be vaccinated at least 1 month before getting pregnant. However, there is no contraindication to vaccinating the children of pregnant women. In addition, according to current recommendations from health organizations around the world, a breastfeeding woman can be vaccinated against chickenpox. Learn more about vaccinations during pregnancy.

If the Parents-to-be have decided to collect and store cord blood, they should always inform the bank about all past infections in the course of pregnancy, including chickenpox and hemiplegia. However, they do not disqualify one from depositing stem cells. https://www.pbkm.pl/komorki-macierzyste/rozwiewamy-watpliwosci

Bibliography:

• “Infectious and parasitic diseases” ed. Science. Anna Boroń-Kaczmarska, Alicja Wiercińska-Drapało PZWL 2017
• “Obstetrics” by G.H. Bręborowicz PZWL 2020.
• Chickenpox and hemiplegia in pregnant and postpartum women. Lukasz Konrad Wysoczanski, Anna Rosner- Tenerowicz, Aleksandra Zimmer, Paulina Natalia Węgierek, Mariusz Zimmer, 2019
• Chickenpox in women in pregnancy. Royal College of Obstetricians and Gynaecologists Guideline No. 13, 2015
• Hemiplegia in pregnancy – case report. Karolina Waleśkiewicz- Ogórek, Forum of Obstetrics and Gynecology