title: Maternal varicella during pregnancy: correlation of maternal history and fetal outcome with placental histopathology.
abstract: The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.
authors.affiliation: Department of Pathology, Hutzel Hospital, Detroit, MI 48201, USA.
authors.forename: F
authors.initials: F
authors.lastname: Qureshi
authors.forename: S M
authors.initials: SM
authors.lastname: Jacques
mesh_terms: D002644:Chickenpox / Q000151:congenital / Q000473:pathology*; D005260:Female; D005315:Fetal Diseases / Q000473:pathology / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000473:pathology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies