Escolar Documentos
Profissional Documentos
Cultura Documentos
15
10
*
5
80
60
HSV-1
40 HSV-2
20
0
CNS Dissemin CNS Dissemin
Mortality Severe Disability
Pediatrics 108 (2): 227, 2001
Peripartum Management of Pregnant
Women with History of HSV
• If no active lesions, normal vaginal delivery
• No current recommendation to culture for mother
or infant for HSV
•Options with active lesions at onset of labor:
If term and ROM <4-6 (?24) hours, C-section
If preterm and ROM, may manage expectantly with
or without acyclovir, betamethasone treatment, etc.
OR may offer C-section
• C-section does NOT eliminate risk of neonatal HSV
Peripartum Management of Pregnant
Women with Possible Primary HSV
• Viral culture of active lesions
• Serological classification if accurate testing
available
• Value of acyclovir is not known
• If 3rd trimester, consider weekly cultures
• primary infection associated with prolonged viral
shedding
• If preterm and ROM, may manage expectantly +/-
acyclovir, betamethasone treatment, etc.
• OR may offer C-section
Management of the Asymptomatic
Neonate Exposed to HSV at Delivery
• For recurrent maternal HSV:
Separate from other newborns, may stay with mom in
private room
Instruct parents re: subtle signs infection, skin lesions