Information that should be provided to a pregnant woman

At booking

Information and advice to pregnant women should reflect the guidance set out in this document. At booking, midwives should:

• Enquire if women have previously had chickenpox or shingles, and if they have not advise that they make urgent contact if they develop chickenpox type vesicles in pregnancy, or have contact with chickenpox or shingles.
• Advise women to inform their midwife, GP or obstetrician urgently if they develop a rash in pregnancy.
• Advise women that they should inform their midwife, GP or obstetrician if they have " contact " in pregnancy with someone who has a rash.

Women presenting with a rash or rash contact during pregnancy

If a woman does present with a rash during pregnancy they should be provided with unbiased information regarding screening and diagnostic tests, the meaning and consequences of both, what to expect in terms of results and further options for management. Women should feel free to exercise whatever options they choose. Minimum standards of information prior to any screening or diagnostic tests done to differentiate the origin of rash in pregnancy should include:

• All tests to establish the initial diagnosis will be on blood samples obtained by phlebotomy. The requirement for more invasive tests, eg amniocentesis, is uncommon, and is only required in the rare situations detailed in this guidance. All tests may uncommonly give inconclusive results, and further testing may be necessary which may prolong the time to result; on occasions, further later sera may be required. If investigation is commenced some weeks after rash or contact, it may not be possible to confirm or refute a possible diagnosis.
• How long the results will take (consult local laboratory).
• Who will give the test results.
• Who will discuss future management of the pregnancy.
• Who they can contact if they have any unanswered queries or concerns.

Written information should be provided to back up verbal advice or information given. The use of an interpreter for women who do not speak English and the use of audio tapes to reiterate verbal discussions indicates good practice. All discussions, advice and care management plans should be documented.

All pregnant women with rash illness, or contact with rash illness, should be referred for medical management.

 

 

 

 

 

Last reviewed: 10 April 2008