• Urgently seek specialist advice regarding the need for diagnostic tests, counselling on the risk of fetal varicella syndrome, antiviral treatment, and follow up:
• Only prescribe an antiviral drug in primary care (with the informed consent of the woman) on the advice of a specialist.
• Offer symptomatic treatment.
• Give advice about contact with other people and when to seek medical advice.
• Monitor the woman closely (review daily, or earlier if her condition deteriorates).
• Refer for urgent hospital assessment if fever persists, or cropping of the rash continues after 6 days.
• Admit to hospital (preferably somewhere with access to specialists in obstetrics, infectious diseases, and paediatrics) if the woman has chest symptoms, neurological symptoms other than headache, haemorrhagic rash or bleeding, severe disease (e.g. dense rash with or without numerous mucosal lesions), or significant immunosuppression.
• Seek specialist advice from the local obstetric unit (even in the absence of complications) if monitoring will be difficult; the woman is in the latter half of pregnancy; or the woman has a complicated obstetric history, history of smoking, chronic lung disease, or poor social circumstances, or is taking steroids.
• Notify the relevant authorities if in Scotland or Northern Ireland (chickenpox is not a notifiable disease in England or Wales).

In depth