วันอาทิตย์ที่ 15 มิถุนายน พ.ศ. 2557

The identification of women that are pregnant who are carriers with the Herpes Simplex Virus type 2 (HSV-2) is a vital concern. Why is genital herpes while pregnant such a worry? Certainly, this STD could cause the mother distressing symptoms. But the real dilemma is for the child she actually is carrying. Infants that are born to females who have ever endured genital herpes are near risk of developing neonatal herpes, a potentially lethal condition.

What is neonatal herpes?

There can be a spectrum of neonatal disease conditions brought on by the herpes virus. This disease spectrum includes:

1. Skin, eye and mouth HSV disease

2. Central nervous system (CNS) HSV disease

3. Disseminated HSV disease

About 45% of infants will build up skin, eye, and mouth herpes lesions. This form of neonatal herpes will be the least severe and will not affect the bodily organs.

30% of infants with neonatal HSV will develop central nervous system (CNS) disease. Neonatal CNS herpes is manifest by:

30% of infants with neonatal HSV will develop central nervous system (CNS) disease. Neonatal CNS herpes is manifest by:

-seizures

-lethargy

-irritability

-tremors

-poor feeding

-poor feeding

-temperature instability

-a bulging fontanelle

Around 25% of neonatal herpes is from the most severe form, disseminated disease. Infants with disseminated herpes infection have multi-organ involvement. These infants can die from severe coagulopathy (defective blood clotting), liver dysfunction, and/or pulmonary failure.

How can expectant women with HSV prevent neonatal herpes of their child?

Guidelines have been established in the management of expectant women who are herpes simplex carriers. These guidelines give you the best odds of preventing neonatal herpes.

Pregnant females who have genital herpes lesions, or prodromal symptoms that suggest a flare is on its way on, before labor will demand a C-section. This is more potent at preventing neonatal herpes in the event the C-section is performed before the membranes have ruptured (water breaking).

A expectant mother may have a known third trimester purchase of genital herpes, put simply, she became have been infected with herpes for the very first time in the third trimester. In this case, most experts recommend a C-section, whether she has signs and symptoms of infection at the time of labor.

A expectant mother may have a known third trimester buying of genital herpes, to put it differently, she became have been infected with herpes to the very first time throughout the third trimester. In this case, most experts recommend a C-section, whether she has warning signs of infection during labor.

An alternate choice is to put mom on suppressive therapy with acyclovir or valacyclovir. Then type-specific antibodies (which cross the placenta to supply protection to the infant) are checked when of delivery.

- If Positive for HSV-2 antibodies a vaginal delivery is possible

- If Negative for HSV-2 antibodies a C-section is required

This alternative option is riskier. The suppressive therapy with acyclovir or valacyclovir might not exactly eliminate viral shedding in the birth canal. Additionally, though antibodies could be present, they may well not provide sufficient passive immunity to the infant in the event the antibody quantities are low.

A mother who has symptomatic genital herpes at 36 weeks gestational age or includes a history of recurrent symptomatic HSV will probably be put on antiviral suppressive medication at 36 weeks before the baby is delivered. Unless essential, your physician will need to avoid invasive obstetrical procedures such as artificial rupture of membranes (AROM), fetal scalp electrode (FSE), and/or Vacuum or Forceps delivery.

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