Re: Herpes in Pregnancy

From: james connerth (babydoc@apex.net)
Mon Aug 16 15:36:27 1999


hOW OFTEN DOES SHE GET A RECURRENCE-AND CAN SHE TELL?Would really be hard pressed to section w/o lesions and especially recurrent disease and presence of maternal antibodies.This may be one rare situation for viral c&s around 38 weeks in an attempt to reassure pt.With her terrible past experience,however,would go out of way to alleviate maternal anxiety---many do c/s for alot less!!!

"Ronald E. Ainsworth" wrote:

> I have a new patient whose first pregnancy delivered vaginally and
> developed severe CNS disease due to genital herpes. Apparently the CNM
> who delivered her "missed" a small herpetic lesion on the vulva and the
> only history of lesions was in her partner. The options, as I see them
> include: 1)perform the cesarean section as requested, 2) follow her
> according to the standard guidelines, with cesarean section only if
> there are lesions present at term or 3)place her on antiviral therapy
> during the last trimester of pregnancy. At this point she is now
> strongly requesting cesarean section. How many would agree to her
> request if she maintains her strong convictions, in spite of medical
> evidence that it is probably an "unnecessary cesarean section?"
>
> --
> Ronald E. Ainsworth, MD, FACOG
> Paradise, CA, Private Practice 20 yrs.





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