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Re: ACOG Preventive med guidelines and Hep BFrom: ainsron@msn.comSun Oct 29 12:03:11 2000
This is the summary from the ACOG practice guidelines regarding herpes and pregnancy: The following recommendations are based on limited or inconsistent scientific evidence (Level B): Women with primary HSV during pregnancy should be treated with antiviral therapy. Cesarean delivery should be performed on women with first-episode HSV who have active genital lesions at delivery. For women at or beyond 36 weeks of gestation with a first episode of HSV occurring during the current pregnancy, antiviral therapy should be considered. The following recommendations are based primarily on consensus and expert opinion (Level C): Cesarean delivery should be performed on women with recurrent HSV infection who have active genital lesions or prodromal symptoms at delivery. Expectant management of patients with preterm labor or preterm premature rupture of membranes and active HSV may be warranted. For women at or beyond 36 weeks of gestation who are at risk for recurrent HSV, antiviral therapy also may be considered, although such therapy may not reduce the likelihood of cesarean delivery. In women with no active lesions or prodromal symptoms during labor, cesarean delivery should not be performed on the basis of a history of recurrent disease.
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-- Ronald E. Ainsworth, MD
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