Rothbarth Ph H Flip, Hartwig Nico G, Opstelten Wim
Nederlandse Vereniging voor Medische Microbiologie, Utrecht, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155(51):A3511.
The multidisciplinary guideline 'Varicella' provides guidelines for diagnosis, therapy, and prevention of chickenpox. At the first pregnancy check, patients should be questioned about previous chickenpox; in case of a negative or doubtful history varicella zoster virus (VZV) serology is indicated. VZV antibody determination is also indicated in patients considered for immunosuppressive therapy and for healthcare workers with a negative VZV history who are in contact with immunocompromised patients. Administration of VZV immunoglobulin within 96 hours following VZV contact can mitigate the infection in pregnant women and patients with T-cell deficiency. VZV immunoglobulin treatment should be considered for newborn infants of mothers who developed chickenpox in the period from five days before to two days after delivery. Antivirals can reduce the severity of infection and are safe during pregnancy. Varicella vaccine protects against chickenpox, but is contraindicated in immunocompromised patients and pregnant women.
多学科指南《水痘》提供了水痘诊断、治疗和预防的指导方针。在首次产前检查时,应询问患者既往水痘病史;若病史为阴性或存疑,则需进行水痘带状疱疹病毒(VZV)血清学检测。对于考虑接受免疫抑制治疗的患者以及VZV病史阴性且接触免疫功能低下患者的医护人员,也建议进行VZV抗体检测。在接触VZV后96小时内给予VZV免疫球蛋白可减轻孕妇和T细胞缺陷患者的感染。对于在分娩前5天至分娩后2天内患水痘的母亲所生的新生儿,应考虑进行VZV免疫球蛋白治疗。抗病毒药物可减轻感染的严重程度,且在孕期使用安全。水痘疫苗可预防水痘,但免疫功能低下患者和孕妇禁用。