Evaluation of pregnant women exposed to respiratory viruses

Prenatal patients are often exposed to respiratory viruses at home and at w ork. Understandably, these patients may be concerned and want immediate ans wers and advice from their physicians. While most women who are exposed to chickenpox are immune, serologic testing can be performed and susceptible p atients can be treated with varicella-zoster immune globulin. If the prenat al patient is infected with the varicella-zoster virus, the risk of fetal m anifestations is less than 2 percent. Women who have been exposed to fifth disease can undergo serologic testing to determine the likelihood of infect ion. If the prenatal patient becomes infected with fifth disease during the first 20 weeks of gestation, the risk of fetal manifestations is about 9 p ercent and includes nonimmune hydrops and death. Cytomegalovirus, which is the most common congenital infection, is generally asymptomatic in the moth er, Infected fetuses have a 25 percent chance of developing early or late n eurologic manifestations. The evidence of harm from other common respirator y viruses is inconsistent.