Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Obstetrics & Gynaecology
Easy
The vaccine that is contraindicated in pregnancy is (OBG):
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- Both MMR (Measles, Mumps, Rubella) and Varicella zoster (chickenpox) vaccines are contraindicated in pregnancy.
- These are live attenuated vaccines, which contain a weakened form of the live virus.
- There is a theoretical risk that the virus from a live vaccine could cross the placenta and infect the fetus, leading to potential harm.
- Specifically, the rubella virus is a known teratogen, and while the vaccine-strain risk is theoretical, it is avoided out of caution.
- Therefore, because both MMR and Varicella are live vaccines, they are contraindicated, making the option 'Both (a) and (b)' the most accurate answer.
Why Other Options Were Wrong
- Option A: This option is partially correct as the MMR vaccine is indeed contraindicated in pregnancy. However, it is an incomplete answer because the Varicella zoster vaccine is also contraindicated.
- Option B: This option is partially correct as the Varicella zoster vaccine is contraindicated. However, it is an incomplete answer because the MMR vaccine is also contraindicated.
- Option D: The Tetanus Toxoid (TT) vaccine is not contraindicated in pregnancy. In fact, it is an inactivated toxoid vaccine that is safe and routinely recommended for pregnant women to prevent tetanus in both the mother and the newborn.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vaccine contraindications during pregnancy as background academic context rather than a clinical decision trigger.
- A crucial nursing responsibility is to assess a woman's immunization status, ideally during pre-conception counseling.
- Non-immune women should be advised to receive live vaccines like MMR and Varicella and then wait at least 1 month before attempting to conceive.
- If a pregnant woman is inadvertently given a live vaccine, she should be counseled on the theoretical risk, but termination of pregnancy is not recommended as no confirmed cases of vaccine-induced congenital syndromes have been reported.
How to Approach the Question
- First, identify the core of the question, which asks for a vaccine that is 'contraindicated' (should not be given) during pregnancy.
- Recall the fundamental principle of vaccination in pregnancy: live attenuated virus vaccines are generally contraindicated due to a theoretical risk to the fetus.
- Categorize each vaccine option: MMR is a live vaccine, Varicella zoster is a live vaccine, and TT (Tetanus Toxoid) is an inactivated toxoid.
- Based on the principle, both MMR and Varicella are contraindicated.
- Evaluate the options. Since both (a) MMR and (b) Varicella are contraindicated, the most comprehensive and correct option is (c) 'Both (a) and (b)'.
- Confirm that TT is safe, which reinforces the correctness of excluding it.
Concept Tested & Keywords
- Concept Tested: Vaccine contraindications during pregnancy
- Stem keywords: vaccine, contraindicated, pregnancy
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
QI2wk8PJlmRrB0pgKhf0C9
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 288-290
E6 Obstetrics Williams p. 61-83
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