What is the recommended action for women without a history of VZV?

Vaccinating postpartum is the recommended action for women without a history of Varicella-Zoster Virus (VZV). The rationale behind this approach is that the varicella (chickenpox) vaccine is a live attenuated vaccine. It is contraindicated during pregnancy due to the theoretical risk of viral transmission to the fetus, which could lead to congenital varicella syndrome.

Administering the vaccine postpartum allows women to develop immunity safely once they have given birth, thereby protecting themselves and future pregnancies. This is particularly important as varicella can lead to serious complications in adults who contract the disease, such as pneumonia or hospitalization.

Conducting more frequent ultrasounds or administering antiviral medications are not standard recommendations for managing VZV status in pregnancy for women without a history of infection. Conducting ultrasounds would not assess VZV immunity, and antiviral medications are not needed in asymptomatic women without a history of the virus. Vaccination during pregnancy is also not appropriate due to safety concerns associated with live vaccines during this time.