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RCOG release: Revised guideline on chickenpox in pregnancy published

News 21 January 2015

Up-to-date guidelines on managing chickenpox in pregnancy are published today by the Royal College of Obstetricians and Gynaecologists (RCOG).

Chickenpox, or primary varicella-zoster virus (VZV), is a common childhood disease that usually causes a mild infection.

Many women have antibodies to protect themselves against the virus after contracting the virus as a child, however, it is estimated that chickenpox complicates three in every 1000 pregnancies.

The revised Green-top guideline, now in its fourth edition, covers prevention of chickenpox in pregnancy, managing women who develop the virus in pregnancy, treatment options, mode of delivery, risks to the baby, advice on breastfeeding and recommendations for future research.

The guidelines state that when women book for antenatal care they should be asked about previous chickenpox/shingles infection. Women who have not had chickenpox should be advised to avoid contact with chickenpox and shingles during pregnancy and to inform healthcare workers of a potential exposure without delay.

Moreover, pregnant women who develop the rash of chickenpox should immediately contact their doctor.

The guidelines also state that women who develop chickenpox in pregnancy should be referred to a fetal medicine specialist and that a neonatologist should be informed of the birth.

The timing and mode of delivery of the pregnant woman with chickenpox must be individualised and women with chickenpox should breastfeed if they wish to and are well enough to do so.

Professor Patricia Crowley FRCOG, from University College Dublin, and co-author of the guideline said:

“Chickenpox is rare in pregnancy and many adults will have had the virus when they were younger and are therefore immune. However, chickenpox can be serious for your health during pregnancy and complications can arise.

“It is vital that pregnant women with symptoms of the virus should contact their GP as soon as possible and avoid contact with potentially susceptible individuals, such as other pregnant women and babies.”

Dr Manish Gupta, co-Chair of the RCOG Guidelines Committee, added:

“Chickenpox is very contagious so it is important that women are aware of the symptoms and the necessity to seek medical attention promptly.

“It is also vital that clinicians are aware of the increased morbidity associated with chickenpox in pregnant women and ensure that the woman receives the best possible care.

“Women may worry about passing the virus onto their baby however this is quite rare and depends on what stage of pregnancy the virus was transmitted.”


For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email

The revised guideline can be found here

To read the RCOG’s Patient Information on chickenpox and pregnancy please click here