Maternal varicella during pregnancy: correlation of maternal history and fetal outcome with placental histopathology.

The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.