Background

Rubella, parvovirus B19, and varicella-zoster virus are the infections which are of most relevance because of their potential impact on the fetus and neonate, however, pregnant women will present with a generalised rash (or contact with a rash) the cause of which may not be clinically apparent. Therefore, the guidance embraces management from the first presentation. It is acknowledged, however, that often, particularly for varicella-zoster, the clinical and/or epidemiological features may be sufficiently suggestive of the aetiology to form the basis of investigation and management.

Infections which may present with a rash illness in pregnant women in the UK include :

• Rubella
• Parvovirus B19
• Varicella-zoster virus
• Measles
• Enterovirus
• Infectious mononucleosis (Epstein-Barr virus, or, very rarely, cytomegalovirus)
• Syphilis
• Streptococcus
• Meningococcus
• A range of other infections not endemic within the UK, and that only need consideration if there is a relevant history of recent travel (e.g. dengue).

Syphilis , streptococcal, meningococcal disease and imported infections are not considered further as clinical and epidemiological information would focus appropriate investigation and diagnosis. Table 1: Characteristics of rubella, parvovirus B19 and varicella-zoster virus infections in the UK shows the characteristic features and incidence of those infections in the UK of particular significance for the fetus - rubella, parvovirus B19, varicella-zoster.