Document Detail

The management of recurrent genital herpes infection in pregnancy: a postal survey of obstetric practice.
MedLine Citation:
PMID:  7547735     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine clinical practice amongst obstetricians in the UK in the antepartum and intrapartum management of pregnant women with recurrent genital herpes infection. METHODS: All Members and Fellows of the Royal College of Obstetricians and Gynaecologists resident in the UK were sent a questionnaire requesting information concerning their management of pregnant women with recurrent genital herpes infection. RESULTS: There was a 76% response rate to the questionnaire. Of the 1201 obstetricians who responded, only 369 (31%) admitted to having a formal policy governing the management of herpes in pregnancy within their unit. However, regular screening was advocated by 718 (60%), of whom 463 (64%) performed regular antenatal swabs for viral culture. At the time of presentation in labour 974 obstetricians (81%) routinely examined the genitals for evidence of a recurrence. When asked in what circumstances caesarean section would be considered an appropriate method of delivery in women with genital herpes infection, 1107 (92%) felt that visible active lesions at the time of labour was sufficient. However, when the membranes had been ruptured for more than four hours in the presence of genital lesions, only 678 (56%) considered this an indication for caesarean section. Caesarean section was more likely to be considered appropriate in this situation by obstetricians who performed antenatal screening (chi 2 = 30.38, P < 0.0001). Five hundred and ninety-six obstetricians (50%) felt that a positive viral culture obtained at antenatal screening from the most recent occasion prior to presentation in labour was an indication for caesarean section, although of this group 192 (32%) said they did not perform antenatal screening by viral culture. The reporting of a recurrence by the patient without visible evidence of disease was considered an appropriate indication for caesarean section by 438 respondents (36%). Maternal request for caesarean section regardless of recurrences at delivery was considered an acceptable indication for operative delivery by 745 obstetricians (62%). CONCLUSIONS: 1. There seems to be little agreement amongst obstetricians in the UK regarding the management of recurrent genital herpes infection in pregnancy. 2. The management possibilities are reviewed and suggestions are made for a more cohesive approach to the problem.
P Brocklehurst; O Carney; E Ross; A Mindel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  102     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-21     Completed Date:  1995-11-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  791-7     Citation Subset:  AIM; IM    
Academic Department of Genitourinary Medicine, Middlesex Hospital, London, UK.
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MeSH Terms
Cesarean Section
Great Britain
Health Policy
Health Surveys
Herpes Genitalis / diagnosis,  therapy*
Physician's Practice Patterns
Pregnancy Complications, Infectious / diagnosis,  therapy*
Prenatal Care
Comment In:
Br J Obstet Gynaecol. 1996 May;103(5):485-6   [PMID:  8624327 ]

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