I am so scared - chicken pox adn pregnancy

[nickytwotimes]

I've posted enough on these threads - didn't want to be the one to start one!

I have no immunity to cp and immunisation didn't work pre-pregnancy. Ds has come out in spots today after classic flu-ey symptoms. I am 33-34 weeks. DOc is arranging to get immunoglobulin for me, hopefully tomorrow.
But I am so scared. This has been a really bad pregnangy - hyperemesis at the start, ds having slapped cheek, pelvic problems. I am near the end now and terrified I come out in spots in a few weeks or so when baby is due. Incubation for sp is 14-21 days so there is a chance theat if baby is a bit early like ds that I will give it to the baby and the risk of mortality in that case is 25 %. I dont know how to get through this.

.

I could just do with someone to hold my fucking hand.

Hi nicky I saw your OP and couldn't let you go unanswered. I'm sorry things have been so scary Has the doc talked through any precautions you can take?

Hi Iggly.
Thanks.
Yes, the immunoglobin might help, but I don;t really understand how it works - if it prevents it developing at all or prevents it crossing the placenta or just mimimises things.

I am so upset because this has beenthe thing I have worried about for years and one of the reasons I put off a second pregnancy for so long.

Oh you poor thing! Sounds very scary. I guess you just have to hope for the best. This is the typical CP season so it's not surprising your ds has caught it now and there is nothing you could have done to avoid it. It's not impossible that your immune system may muster enough to fight it off though is it - even if you haven't had immunity before tings could change at any time couldn't they? I know it's unlikely - but something to cling too nevertheless?

Again, didnt want it to go unanswered but have no knowledge of this. I am shocked at the 25% statistic - is there anything they can do to reduce that risk do you know?

Are you seeing the doctor again? Can you go back or get your midwife to ring someone with more knowledge to get further information for you?

Thanks NL.
I am crossing things.
Doc is getting lab to re-check my bloods before issuing the immunoglobulin.
I am scared of it too - don;t know how it works and NHS doesn't really explain on website.

Oh, I am just going out my head with worrying. I know there are worse thing that could happen when you are pg, but I have feared this as I say. Dh is trying to keep me calm, but to little avail!

peppa, yes, I was surprised by mortality rate too. It can be reduced by careful post-natal observation, but cp in newborns is really, really bad news. I don't think many people know how dangerous cp is because most of the time it is a mild illness.

Hopefully the doctor can talk you through this, timings, effectiveness etc.

I really don't know what to say but feel really bad for you. Have you got someone in RL to give support?

Aye, dh is a good 'un.

Ds is up again, itchy.

I'll need to bugger off for a bit. Back later hopefully.

Thank you all very much for replying. I'll look in again later.

Hi nickytwotimes

I am a Paediatrician and I would advise you to try not to worry too much. If you are not immune and you have been in contact with chickenpox then the immunoglobulin would be given with the intention of you NOT developing the illness yourself (and therefore not passing it on to the baby) or to minimise the severity of the illness. It is a miserable disease to have as an adult but it can be risky to the mother in pregnancy (when your immune system is low naturally) and your team would want to protect you as much as possible. If you were unlucky you can be treated.

If you were to develop chickenpox then the riskiest time is 5 days before to 2 days after birth, as your baby would be exposed to the virus and could be infected. HOWEVER if you contracted chickenpox before that, you would have time to produce some antibodies against chickenpox (the things your body produces in response to an infection which will give you immunity after exposure). Antibodies like these cross the placenta and give babies immunity passively (ie without their system having to do anything).

If you were unlucky enough to have the infection close to the birth, your local paediatric team would be notified and after birth would give your little one an injection of VZIG, or Varicella Zoster Immunoglobulin (essentially an injection to replicate the body's immunity to the chickenpox virus) - the same injection they want to give you. This is usually protective, but if he/she developed symptoms they could also be given intravenous antiviral medication (aciclovir) to further protect them.

I have seen quite a few babies whose mothers have had chickenpox close to the birth and with these measures all have been fine.

Does this help?

Glad to hear DH is supportive. I know 25% is a rubbish stat but 75% are ok. Fingers crossed that it works out.

We could almost be pregnancy twins - I've had chickenpox near term and parvovirus at pre 20wks too!

I had chicken pox at 36+ with my first child and he arrived at 37+5. I had no immunity either and was lucky that my own attack wasn't that bad - it can be really nasty in adults that have never had it before. I spoke to my doctors and midwives and we made the decision to go ahead with our home birth as all my spots had been scabbed for a few days before I went into labour. Given your timing I think you might actually be okay. If you're 34wk now, 3wks incubation puts you at 37wk, which still gives you a week to scab over to 38wks - which would still be really quite early for baby to make an appearance. Also, please try and understand that the mortality stats for babies of those with maternal chickenpox at term are not a blanket 25%, but vary up to that level dependent on a whole host of circumstances - the fact that you and your team are aware of your exposure and will be watching for developments very closely will go a long, long way to mitigating that potential. Can you get to speak to your midwife tomorrow and ask her to reassure you about the observations and precautions you can both take in terms of protecting the baby?

It's also really good that your doc is getting you immunoglobulin - I wasn't offered this as of course we didn't know I had been exposed until I came out in spots, by which time it was too late. And I had slapped cheek (i.e. parvovirus) during the most risky period with my second child. So I do know what you are going through in terms of worry, and really do want to hold your virtual hand. Please try and take care of yourself and lean on all the support you have, just talking it out rather than having it turn over and over inside your head can help.

Really thinking of you and feeling for you x

I wonder if the 25% is quite an old figure as it sounds like the measures Kitty outlines should reduce that risk a lot?

Yes Kitty, that is a big help, thank you!

I have poxy child by my side now, snuggled in, trying to push buttons.

I am pleased that there is a good chance immunoglobulin can prevent infection. That would be wonderful! Also good to know about the treatment for newborns if necessary.

Thanks so much.

Thanks sparkle.
Glad you all survived well and intact.
I am sure logically that everything will be okay. I am hormonal and over thinking and stuff is going round and round in my head as you say. What ifs, etc...
NL, yes, what Kitty describes does sound like it would grately reduce any problems.

I would be very scared as well - overthinking it is a totally normal and understandable reaction!

I have done a quick literature search on this. The 25-30% mortality statistic appears to be based on old data. There have been a few studies with lots of babies where doctors have treated infants with VZIG; in these cases 33-71% do not develop the disease, and the majority of those who do have a very mild course. There were no deaths recorded in these studies. The old statistic doesn't seem to take into consideration how effective VZIG is, or drugs we can treat with, or even how good modern medical care is. I can also tell you that in 10 years of paediatrics I have NEVER seen a baby die of chickenpox acquired in these circumstances. The important thing is that even if you deliver in the risky time there are things that can be done - babies that have had problems have been late pick-ups where people weren't aware of what to watch out for.

Get some calamine for DS and try to enjoy your pregnancy!

That's a great round up Kitty and will be of immense use to many women on this site not just the op. Thanks for taking the time to do that.

Hi everyone and thank you so much for holding my hand last night.

Feeling much better today. Got the immunoglobulin today and doc is hopeful it will prevent me getting cp at all. He was also very reassuring wrt timing for baby. And sang the praises of VZIG/anti virals in general!

Ds is much better too. Still whiney, but much better than before.

That is great information Kitty. I will be quick to direct anyone worrying about cp in late pg or post-partum to this thread in the future.

So glad you've had some support from this thread, and that your doctor has been really on the ball too. Here's hoping you escape scot free

Just to add to the reassurance, I had CP when I was 36 weeks, had no problems at all (but DD2 was a week late). Try not to worry and look forward to your new arrival. Good luck.

Thaks guys.
Good to know you survived it too Mrs Depp.

nicky just checking in - I hope you're ok. Keep us posted!

Bugger.
I have suspicious looking blister spots on my stomach, sides a back tonight.
On the plus side, I haven't been feeling ill, just a bit crummy like normal late pg, so maybe a very mild dose? Will get looked at tomorrow at doctors.
I am not too worried though thanks to this thread and your reassurances. Thank you.