Varicella Vaccination During Early Pregnancy: A Cause of<i>in utero</i> Miliary Fetal Tissue Calcifications and Hydrops?

Apuzzio, Joseph J.; Ganesh, Vijaya; Iffy, Leslie; Al-Khan, Anthony

doi:10.1155/s1064744902000169

Cited by 8 publications

(3 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surprisingly, the findings in this case were similar to that reported by Apuzzio et al,11 who suspected that inadvertent vaccination with varicella vaccine during early pregnancy might be associated with miliary fetal tissue calcifications and hydrops. Therefore, our case is evidence supporting their hypothesis on the cause–effect of varicella vaccine and congenital varicella syndrome.…”

Section: Discussionsupporting

confidence: 91%

Prenatal sonographic diagnosis of congenital varicella syndrome

Tongsong

Srisupundit

Traisrisilp

2012

J of Clinical Ultrasound

View full text Add to dashboard Cite

Congenital varicella syndrome is a rare disorder occurring in less than 1% of maternal varicella during early pregnancy but is associated with high fetal morbidity and mortality. This case report aimed to describe the sonographic features of congenital varicella syndrome following maternal varicella. Well-documented maternal chicken pox was made at 12 weeks of gestation and prenatal ultrasound was performed at 16 weeks. Striking sonographic features included hydropic changes and disseminated calcifications in multiple organs, especially liver and myocardium. Elective termination of pregnancy was done at 17 weeks. The presence of disseminated calcifications could suggest the diagnosis of congenital varicella syndrome.

show abstract

Section: Discussionsupporting

confidence: 91%

Prenatal sonographic diagnosis of congenital varicella syndrome

Tongsong

Srisupundit

Traisrisilp

2012

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…Smallpox vaccination in pregnancy has been associated with club foot mal- formations in one report [18]; other reviews have refuted such an association [12]. Given that the cause of most congenital anomalies is unknown and that some have argued that live virus vaccines given during pregnancy might cause birth defects [19][20][21][22], more information is needed to understand the risk of infant health problems after maternal smallpox vaccination. Because of the risk of fetal vaccinia, smallpox vaccine is generally contraindicated during pregnancy.…”

mentioning

confidence: 99%

Pregnancy, Birth, and Infant Health Outcomes from the National Smallpox Vaccine in Pregnancy Registry, 2003–2006

Ryan

Seward

2008

CLIN INFECT DIS

View full text Add to dashboard Cite

When the United States implemented civilian and military smallpox vaccination programs in 2003, the National Smallpox Vaccine in Pregnancy Registry was established to better evaluate outcomes after the inadvertent vaccination of pregnant women. Women were referred to the registry by vaccine administrators, health care providers, or state health departments or through self-referral. Registry professionals actively follow up with all enrolled women and collect data on pregnancy, birth, and infant health outcomes. As of September 2006, pregnancy outcome data were available from 376 women. Most (77%) were vaccinated near the time of conception, before results of a standard pregnancy test would have been positive. To date, outcome evaluations have not revealed higher-than-expected rates of pregnancy loss (11.9%), preterm birth (10.7%), or birth defects (2.8%), compared with those in healthy referent populations. No cases of fetal vaccinia have been identified. The Smallpox Vaccine in Pregnancy Registry continues to actively enroll women and follow infant and early-childhood health outcomes.

show abstract

“…93 Because varicella vaccine is a live attenuated virus, it is contraindicated in pregnancy. 94 The US Advisory Committee on Immunization Practices recommends avoiding pregnancy for one month after vaccination. 85 However, pregnant women who are inadvertently vaccinated can be reassured.…”

Section: Primary Preventionimmunizationmentioning

confidence: 99%

Fetal varicella – diagnosis, management, and outcome

Mandelbrot

2012

Prenatal Diagnosis

View full text Add to dashboard Cite

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.

show abstract

Varicella Vaccination During Early Pregnancy: A Cause ofin utero Miliary Fetal Tissue Calcifications and Hydrops?

Cited by 8 publications

References 2 publications

Prenatal sonographic diagnosis of congenital varicella syndrome

Prenatal sonographic diagnosis of congenital varicella syndrome

Pregnancy, Birth, and Infant Health Outcomes from the National Smallpox Vaccine in Pregnancy Registry, 2003–2006

Fetal varicella – diagnosis, management, and outcome

Contact Info

Product

Resources

About