Risk of varicella infection during late pregnancy

Question. I have a patient who contracted varicella at 26 weeks' gestation. She is very concerned and would consider termination if it were earlier in the pregnancy. What are the current predictions of risk for her fetus? Answer. Based on review of all available studies, we could not detect a single case of congenital varicella syndrome in the third trimester of pregnancy (0/208), as compared with 5/645 (0.78%) in the first and 9/592 (1.52%) in the second trimester (P <.01 third vs first and second). You can reassure your patient.