Management of herpes zoster (shingles) during pregnancy.


eMediNexus    18 May 2018

A new article published in the Journal of Obstetrics and Gynaecology reported that although less frequently, the incidence of herpes zoster (HZ) has been recorded during pregnancy, wherein the risk of maternal morbidity increases. In the advent of varicella-zoster virus (VZV) infection, patients usually present with a viral prodromal symptoms, which is followed by appearance of the characteristic zoster rash. Zoster rash is the diagnostic clinical feature of this viral infection; confirmatory investigations include polymerase chain reaction and enzyme-linked immunosorbent assay. The authors stated that uncomplicated HZ during pregnancy should be treated with oral antiretroviral drugs, for instance, acyclovir. Complications of HZ are subacute herpetic neuralgia, post-herpetic neuralgia, ophthalmicus, disseminated HZ, and secondary bacterial infections. However, the varicella and the zoster vaccines are not recommended for pregnant women, besides non-immune pregnant women should be advised to avoid an exposure to VZV. In summary, it was stated that HZ infection has minimal effect on the fetus, but maternal HZ and its complications cause a significant burden.

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