North American Registry of Midwives (NARM) Practice Exam

If a non-immune woman is exposed to varicella during pregnancy, what is the recommended course of action?

1. Administer antiviral medication immediately

2. Provide Varicella-Zoster immune globulin within 96 hours

3. Isolate the mother and baby immediately

4. Monitor for symptoms for 2 weeks

The correct answer is: Provide Varicella-Zoster immune globulin within 96 hours

When a non-immune woman is exposed to varicella (chickenpox) during pregnancy, the recommended course of action is to administer Varicella-Zoster immune globulin (VZIG) within 96 hours of exposure. This is because VZIG can help reduce the severity of the disease if the woman were to develop varicella during pregnancy, offering passive immunity and protecting both the mother and the fetus. In such cases, timely intervention is critical, as maternal varicella infection during pregnancy can lead to complications such as pneumonia or congenital varicella syndrome in the newborn. The effectiveness of VZIG decreases significantly after the 96-hour window, making prompt administration essential for optimal protection. Other options, while they may seem relevant, do not provide the specific protective benefits that VZIG offers in this scenario. Administering antiviral medication immediately may not be recommended unless the mother develops symptoms of varicella. Isolation of the mother and baby is generally not necessary solely due to exposure if prophylaxis is administered. Monitoring for symptoms is also important but does not provide immediate protective benefits against the potential consequences of maternal varicella infection during pregnancy. Thus, providing Varicella-Zoster immune globulin is the best practice in