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Re: ACOG Preventive med guidelines and Hep B From: Debby Burroughs (dburro@mindspring.com) Sat Nov 4 08:54:24 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Paul Prior MD: "Re: OB: Varicella Vaccination" Previous message: Garry Siegel: "OB: Varicella Vaccination" Ginny, I'm a L&D nurse working to clarify and update our policies regarding HSV patients. You mentioned in your post below that, rather than suppression treatment at term, a speculum exam and careful external exam is done when she presents to L&D. Do you have a guideline or position statement that recommends this approach? I'm specifically looking at the nursing role when the patient presents with a history of HSV but no symptomatic lesions at the time. Thanks for your assistance -- Debby Burroughs, RNC, BSN dburro@mindspring.com >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 > Next message: Paul Prior MD: "Re: OB: Varicella Vaccination" Previous message: Garry Siegel: "OB: Varicella Vaccination"

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