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Infectious Diseases in Obstetrics and Gynecology
Volume 4, Issue 6, Pages 338-346
http://dx.doi.org/10.1155/S1064744996000683
Obstetrical Case Report

Varicella Pneumonia Complicating Pregnancy: A Report of Seven Cases

Department of Obstetrics and Gynecology, University of Tennessee Medical Center, 1924 Alcoa Highway, Box U-28, Knoxville 37920, TN, United Kingdom

Received 9 July 1996; Accepted 14 January 1997

Copyright © 1996 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Pneumonia is the most common complication of varicella-zoster infection in adults and has potentially devastating effects when complicating pregnancy. Due to the significant morbidity and mortality associated with this complication during pregnancy and the small number of reported cases in the literature, we present this report to help educate physicians who care for pregnant women.

Cases: Seven patients are presented in this report. These patients presented at various stages in pregnancy, from 17 to 31 weeks of gestation. Three of the patients had unremarkable hospital courses. Three of the patients had hospital stays over 21 days in duration. One patient died from complications of varicella pneumonia after 31 days of hospitalization. The obstetric outcomes of the 7 patients described include 1 non-viable delivery at 20 weeks gestation, 3 term deliveries, 2 preterm deliveries, and 1 patient who has not yet delivered. All of the patients presented were treated with intravenous acyclovir therapy. Of the patients described, 3 required intubation and ventilatory support. Other complications encountered include disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), metabolic encephalopathy, pneumothorax, superimposed bacterial pneumonia, and sepsis.

Conclusion: The course and treatment of varicella pneumonia complicating pregnancy are discussed. Current recommendations regarding the use of varicella-zoster immune globulin (VZIG) are also reviewed.