Re: [ozmidwifery] genital herpes in pregnancy

[Marilyn Kleidon]

Hi Nicole:   I could not add anything to the information obtained on the sites recommended by both Sally and Jane. I do think it is worthy to note that doctors in the USA were reluctant to change their recommendations for C/s delivery for women with recurrent herpes with lesions in labour. This is despite evidence to the contrary and testimony by their colleagues in Europe. I suspect this is because the consequences of neonatal herpes are considerable and while the risk of transfer of HSV to the neonate is low it isn't zero or equivalent to the risk of women with a history but no lesions in labour or women with no history and no lesions. Perhaps prevention is an option and this can be via the various regimens of oral acyclovir to be prescribed by GP from 34-36 weeks or Vitamin C and garlic and lysine(see  gentlebirth site for various regimens). If the woman's immune system is not compromised then these medications are probably unnecessary as she will most likely pass the immunity passively to her newborn. It is the assessment of her immune status and the passage of the immunity to her baby which is the grey/unknown entity here (in the presence of lesions in labour).   I have to admit my information is ALL theoretical, I have cared for women with a history of hsv but none of them have EVER presented with lesions in labour or even in the last 4 weeks of pregnancy. One of these women was very anxious and did have me do a cervical swab for hsv at 40 weeks: negative result and birth a couple of days later of vigorous healthy baby, at home, Seattle. This swab was in a special pack with specific guidelines for its use and we had to obtain is specially from the path lab. i don't know if it is available for use here or even its efficacy.   marilyn   marilyn ----- Original Message ----- From: Nicole Christensen To: [EMAIL PROTECTED] Sent: Thursday, April 15, 2004 6:01 AM Subject: [ozmidwifery] genital herpes in pregnancy Hi all, I posted a query last year re. genital herpes in pregnancy. I received one reply off the mailing list - thank you..... BUT would like to try again to see if ANYONE can give me ANY information or tell me of their experiences with women who have active lesions when in labour. With apparently 1 in 10 women suffering from genital herpes - this MUST be something that midwives are coming across in their practice. My girlfriend is 24 weeks pregnant - and unfortunately going with a private obs. He has TOLD her that if she doesn't have any active lesions when in labour - he will ALLOW her to try for a natural birth... BUT if she has a lesion - then it is an automatic c/s - no ifs or buts. (This is the same obs that gives his clients stickers for not putting on alot of weight in pregnancy!!! ) I just find it hard to believe that active genital herpes should automatically result in a c/s... and am infuritaed that my friend is TOLD what will happen when it comes the time to birth her precious first baby!!! The little info. I have got - says very explicitely, that genital herpes is really only a risk if the mother contracts it (for the first time) DURING the pregnancy. The chance of baby contracting herpes or complications related to the mother's genital herpes (if already having herpes BEFORE pregnancy) is I think, something as little as 0.04%!!!! SO, WHY IS THIS AN AUTOMATIC C/S????????!!!!!!!!!!! I have also heard of putting an op-site over the lesion during birth....(?????????). PLEASE - could ANYONE tell me of their experiences; any information they have.... or where I could find any information on it. With 1 in 10 women having this - it must be something that you are faced with at some time!!!!  Thank you! thank you! thank you!!! regards, Nicole