Supplementary Material for: Varicella Zoster Virus Reactivation in the Cervix During Labor in a Vaccinated Pregnant Woman: A Novel Case Report

Introduction Obstetric and pediatric providers are increasingly challenged by the evolving presentations of perinatal infections. While varicella zoster virus (VZV) reactivation during pregnancy is typically considered benign and poses a low risk for neonatal transmission, this assessment is based on dermatomal, non-genital presentations. Genital involvement, especially when isolated to the cervix, is rare and not addressed in the current guidelines. Case Presentation We present the case of a fully vaccinated, immunocompetent 22-year-old woman with cervical VZV infection at the time of delivery. She was suspected to have reactivation of the vaccine strain and was delivered via caesarean section. The infant remained asymptomatic and did not require therapy to prevent or treat the infection. Conclusion This case underscores the diagnostic utility of multiplex viral testing and highlights a critical gap in the guidelines for managing genital VZV reactivation during pregnancy. Genital VZV, similar to herpes simplex virus, may warrant special consideration in delivery planning and neonatal care.引言 产科与儿科临床医师正日益面临围产期感染多样化临床表现带来的诊疗挑战。尽管妊娠期间水痘带状疱疹病毒（Varicella Zoster Virus, VZV）再激活通常被认为是良性过程，且新生儿传播风险较低，但该结论仅基于皮节型、非生殖器部位的临床表现。而生殖器部位受累（尤其是仅累及宫颈者）较为罕见，现有指南尚未对此类情况作出相关规范。 病例报告 本文报告1例足月分娩时确诊宫颈VZV感染的22岁育龄女性，该患者既往已完成全程疫苗接种，免疫功能正常。临床怀疑其为疫苗株病毒再激活，最终通过剖宫产完成分娩。新生儿无任何临床症状，无需接受感染预防或治疗干预。 结论 本病例凸显了多重病毒检测的临床诊断价值，同时也揭示了当前针对妊娠期间生殖器VZV再激活的诊疗指南存在的重大空白。与单纯疱疹病毒（Herpes Simplex Virus）类似，生殖器VZV感染或许需要在分娩计划与新生儿护理环节中得到特殊关注与考量。