title: Fetal varicella - diagnosis, management, and outcome.
abstract: Fetal varicella syndrome (FVS) is due to transplacental infection by the Varicella zoster virus following maternal infection. The risks for the fetus and neonate depend on the timing. When varicella occurs around delivery, it often leads to disseminated neonatal varicella. When varicella occurs during pregnancy, transmission can occur, but is usually asymptomatic; some infants develop zoster postnatally and a few have FVS. Before 20 weeks' gestation, FVS can occur, with an incidence of about 1%. The lesions can affect the skin, limbs, central and autonomous nervous systems, eyes, cause calcifications, and growth retardation; mortality is high. Lesions typically follow one or several nerve territories, suggesting that damage results from in utero zoster following primary fetal infection. There has been little study of prenatal diagnosis of FVS. Serial ultrasound examination can detect various anomalies, magnetic resonance imaging can be of use to investigate for microphthamia and cerebral lesions, and amniocentesis can diagnose viral transmission. Prevention strategies include vaccination and post-exposure prophylaxis with immune globulin and/or antivirals. Perspectives for treating infected fetuses in utero require further research.
authors.affiliation: Hopital Louis Mourier, Service de Gynécologie-Obstétrique, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, Université Paris-Diderot, 178 rue des Renouillers, 92701, Colombes cedex, France. laurent.mandelbrot@lmr.aphp.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Mandelbrot
mesh_terms: D002644:Chickenpox / Q000175:diagnosis* / Q000196:embryology* / Q000517:prevention & control; D019433:Chickenpox Vaccine; D005260:Female; D005313:Fetal Death / Q000821:virology; D005315:Fetal Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D007114:Immunization; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011296:Prenatal Diagnosis; D011379:Prognosis; D013577:Syndrome; D016216:Ultrasonography, Prenatal
chemical_list: D019433:Chickenpox Vaccine