Management of varicella-zoster virus primary infection during pregnancy: A national survey of practice

• Varicella (VZV) infection in pregnancy can result in serious maternal pneumoniae.
• Varicella (VZV) infection in pregnancy can result in congenital varicella syndrome.
• Varicella (VZV) infection in pregnancy can result in severe neonatal varicella.
• The consequences of VZV primary infection in pregnancy are poorly known.
• Health care providers should update their knowledge of varicella infection during pregnancy.

BackgroundVaricella (VZV) infection in pregnancy can result in serious outcomes: maternal pneumoniae irrespective of the term of pregnancy, and lead to congenital varicella syndrome before 18 weeks of gestation and neonatal varicella. There are between 350 and 500 cases a year in France. Until now, there have been no scientific obstetrical guidelines for clinical practice in France for VZV infection during pregnancy.ObjectivesTo evaluate health care providers’ knowledge and practices concerning varicella infection during pregnancy in France.Study designAn anonymous survey on VZV infection was sent by e-mail to gynecologists-obstetricians and midwives. We evaluated their knowledge and practices concerning VZV transmission, maternal varicella, congenital varicella syndrome, neonatal varicella and prevention.ResultsThe survey was completed by 271 professionals: gynecologists (161/271; 60%) and midwives (110/271; 40%). Among 20 items, 5 were multiple choice questions. 29 correct answers were expected. Scores ranged from 6/29 to 28/29 (mean score: 17.44/29).ConclusionsThe consequences of VZV primary infection in pregnancy are poorly known. We reveal a diversity of management among practitioners in our study population, not always in accordance with the international scientific literature or with the guidelines of other countries. Health care providers should update their knowledge of varicella infection during pregnancy. The publication of national guidelines could help to achieve this objective.