----- Original Message -----
Sent: Saturday, April 17, 2004 4:00
AM
Subject: Re: [ozmidwifery] genital herpes
in pregnancy
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 -----
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
