Maternal Acyclovir.Pregnant women with herpes simplex herpes simplex (hûr`pēz), an acute viral infection of the skin characterized by one or more painful, itching blisters filled with clear fluid. lesions usually undergo cesarean section cesarean section (sĭzâr`ēən), delivery of an infant by surgical removal from the uterus through an abdominal incision. The operation is of ancient origin: indeed, the name derives from the legend that Julius Caesar was born in this to prevent the newborn from acquiring herpes infection (with its serious repercussions repercussions npl → répercussions fpl
repercussions npl → Auswirkungen pl ) during passage through the vagina at birth. A decision analysis compares this expensive approach with other strategies for mothers with recurrent genital herpes Genital Herpes Definition
Genital herpes is a sexually transmitted disease caused by a herpes virus. The disease is characterized by the formation of fluid-filled, painful blisters in the genital area. : acyclovir acyclovir /acy·clo·vir/ (a-si´klo-ver) a synthetic purine nucleoside with selective activity against herpes simplex virus; used as the base or the sodium salt in the treatment of genital and mucocutaneous herpesvirus infections. prophylaxis in late pregnancy, followed by C-section if lesions are present at delivery; acyclovir prophylaxis and vaginal delivery, with culture and treatment of the newborn; or no intervention.
Based on assumptions derived from published studies, performing C-sections on all women with genital herpes at delivery was estimated to prevent 2.8 cases of neonatal herpes and lead to 1082 C-sections per 10,000 women with recurrent genital herpes. Acyclovir prophylaxis plus C-sections for women with lesions would prevent 5.5 cases and lead to 216 C-sections per 10,000. Prophylaxis with vaginal delivery and infant culture would prevent 5 cases; and no intervention would result in 6.2 to 7.6 neonatal herpes cases.
The conclusion was that acyclovir treatment of genital herpes in late pregnancy not only prevents more neonatal herpes cases than cesarean section without treatment, it is also cost-effective. Acyclovir plus C-section in cases of active lesions was deemed by the journal to be optimal therapy. (That is, they concluded that it was worth 216 cesarean sections to prevent 0.5 cases of neonatal herpes per 10,000 women with recurrent genital herpes.)
Since acyclovir has not been approved by the FDA FDA
Food and Drug Administration
n.pr See Food and Drug Administration.
n.pr the abbreviation for the Food and Drug Administration. for use in pregnancy, patients offered acyclovir should be informed that, while few data exist, it does not seem to be harmful based on anecdotal evidence.
--Journal Watch: Women's Health, 12/96