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Obstetrics > Genital HSV in Pregnancy > Flashcards

Genital HSV in Pregnancy Flashcards

1
Q

What type of HSV accounts for the majority of genital infections?

A

HSV1 (80%)

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2
Q

What percentage of primary HSV infections are symptomatic?

A

5 - 15%

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3
Q

What are the main symptoms associated with primary HSV infection?

A

fever, painful skin lesions, malaise, ingunal adenopathy

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4
Q

Which type of HSV is more infectious?

A

HSV2

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5
Q

What is the definition of a nonprimary first episode?

A

Infection with a second strand of HSV, BUT antibodies present and shorter duration of viral shedding

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6
Q

How do you diagnose HSV?

A

HSV PCR from lesion

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7
Q

What is the rate of intrauterine infection following maternal primary infection?

A

1/200,000

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8
Q

What neonatal findings are associated with vertical HSV transmission?

A

Chorioretinitis, microcephaly, skin lesions

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9
Q

What is the rate of transmission at delivery in a patient with a primary HSV infection?

A

30 - 60%

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10
Q

What is the rate of transmission at delivery in a patient with a recurrent HSV infection?

A

3-5%

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11
Q

What should be the mode of delivery in a patient with recurrent back, thick and buttock HSV lesions?

A

Vaginal delivery

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12
Q

How should a primary HSV infection be treated?

A

7-10 days of : Acyclovir 400 mg PO TID, Valcylovir 1000mg po BID, Famciclovir 250 mg PO TID

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13
Q

How should a recurrent HSV infection be treated?

A

5 days of: Acyclovir 400 mg PO TID, Valcylovir 1000mg po BID, Famciclovir 125mg PO TID

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14
Q

What is the regimen for HSV supression in pregnancy?

A

400 mg Acyclovir TID

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15
Q

When should you start supression for HSV in pregnancy?

A

36wga

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16
Q

If patient with HSV is placed on supression during pregnancy, the rate of recurrence decreases by ____ at the time of delivery and the rate of CS delivery decreases by_____.

A

75%, 40%

17
Q

Which pregnant patients should be given HSV supression?

A

Women with > 2 outbreaks per year

18
Q

What percent of neonates with HSV have disseminated infection?

A

25%

19
Q

What percent of neonates with HSV have CNS infection?

A

30%

20
Q

What percent of neonates with HSV have skin,eyes or mouth infection?

A

45%

21
Q

What is the mortality associated with disseminated neonatal HSV infection?

A

30%

22
Q

What is the mortality associated with neonatal HSV with CNS involvement?

A

4%

23
Q

What percentage of infants who survive disseminated HSV infection will have long term neurological sequelae?

A

20%

Obstetrics (28 decks)

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