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Re: ACOG Preventive med guidelines and Hep BFrom: Edgardo Rivera (rive161@attglobal.net)Thu Oct 26 22:25:17 2000
At Thu, 26 Oct 2000, ginny lee BSN, GNM wrote: > >At Thu, 26 Oct 2000, Efrain Ramirez wrote: >> >>You are right about cross reaction but read about "Pockit" - type >>specific - highly sensitive - $60 though - >> >Hope this is not a stupid question, but why do titers on all women for >HSV when delivery would be vaginal, even if positive titers, in absence >of lesions? >ginny Generally, if a pregnant woman has Hx of genital herpes, and you can verify this by pockit test or the test of your preference., This patient can be supress by any antiviral therapy such as famvir(cat B), after 36 wks g/a to decreased the posibility of active lesion at the moment of delivery, and vertical transmission of the baby. Also think about the posibility to test patient and partner(husband... or else). She could be negative for Pockit and him could positive, and if she get primary herpes while pregnant, the posibility of vertical transmision is greater than if she has it before. So you might want to think about supressing with antiviral therapy him to lower the posibilty of shedding Also we do routine HIV and VDRL test. Very rare in my practice, on the other side the prevalence of Herpes is very common.....1/8 HSV-2 So think about universal screening
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