Document Detail

Herpes simplex virus infection after vacuum-assisted vaginally delivered infants of asymptomatic mothers.
MedLine Citation:
PMID:  14973511     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether vacuum extraction technique is associated with an increased risk of herpes simplex virus (HSV) infection in infants born to asymptomatic mothers. PATIENTS AND METHODS: We reviewed the charts of all infants born at the Edith Wolfson Medical Center and admitted to the hospital's neonatal intensive care unit from January 1999 to June 2002 diagnosed with HSV infection. RESULTS: During the study period, 6953 infants were delivered at our institution and 11 infants had HSV infection. The prevalence of neonatal HSV infection was 1.6 per 1000 live births. In 699 infants, vacuum extraction was used for delivery. Five out of the 11 infants delivered vaginally by vacuum extraction developed HSV infection at the site of the vacuum extractor application. They were born to mothers who were asymptomatic at delivery and had no history of HSV genital infection. HSV type 2 was isolated from the vesicular fluid in all infected infants delivered by vacuum extraction, and none had central nervous system involvement. The prevalence of neonatal HSV infection in vacuum-assisted births was seven per 1000 live births as compared to 0.95 in 1000 in infants delivered vaginally or by cesarean section (p<0.0001). The relative risk of HSV infection in infants born in vacuum-assisted births was 7.45 (95% confidence interval (CI) 1.99 to 27.42, p=0.001). All patients were treated with intravenous acyclovir and no recurrences of HSV infection have been noticed at follow-up. CONCLUSIONS: Laceration of the fetal scalp by vacuum extraction technique may enhance the acquisition and the early appearance of cutaneous infection in infants exposed to HSV shedding in the genital tract of asymptomatic mothers, as the virus gains access through the lacerated scalp.
David Kohelet; Neriel Katz; Oscar Sadan; Eli Somekh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  24     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-26     Completed Date:  2004-07-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-9     Citation Subset:  IM    
Department of Neonatology, Edith Wolfson Medical Center, Holon, Israel.
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MeSH Terms
Herpes Simplex / etiology*
Infant, Newborn
Lacerations / virology
Pregnancy Complications, Infectious*
Retrospective Studies
Scalp / injuries,  virology
Vacuum Extraction, Obstetrical / adverse effects*

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