|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Herpes in PregnancyFrom: Malcolm Griffiths (Malcolm@MGRIFF22.demon.co.uk)Mon Aug 16 16:54:47 1999
In message <199908162014.PAA20877@talk.obgyn.net>, Ronald E. Ainsworth <ainsron@msn.com> writes >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?" > Who says the CNM missed a small herpetic lesion? The likelihood is that the child develeoped CNS HSV infection from some other or unidentified source. The most recent fatal neonatal HSV was linked to granny's cold sore! I would discuss the matter in great detail. Advise that CS is likel to be unnecessary. Consider option of anti-HSV prophylaxis. Ultimately let her have CS if that was what she still wanted at 38 weeks. Counsel her that CS was no guarantee! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "EXPERIENCE: SOMETHING YOU DON'T HAVE UNTIL AFTER YOU NEEDED IT!"
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:29:03 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.