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Re: ACOG Preventive med guidelines and Hep BFrom: ginny lee BSN, GNM (kaupilimakoa@hotmail.com)Thu Oct 26 23:28:57 2000
Most of the practices I am familiar with (including level III teaching hospital) do not routinely put women with a history of genital herpes on suppression at term, rather they do careful external/speculum exam when she presents to L&D. Transmission to baby during a recurrence is rare, even rarer if the woman has an asymptomatic outbreak. I can see a negative test for reassuring the woman that she is herpes free, but primary outbreaks are usually pretty painful...Plus, if the test is useful for diagnosing a primary outbreak, how would you know to check for herpes if she is asymptomatic (and not having the typical picture for a primary episode)? Also, just because she is HSV neg at the beginning of the pregnancy doesn't mean she will be at term--would you advocate screening again in the third trimester...seems pretty costly. just curious aloha ginny
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