----- 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
