HSV Flashcards
What % of neonatal HSV infection is localised to the eye skin and or mouth
30%
What is the mortality from neonatal HSV local CNS infection
30%
17% permanent neurology
What is the increased risk of miscarriage and congenital infection with primary HSV in the first trimester
Nil
What is the risk neonatal infection with primary HSV infection with 6 weeks of delivery
41%
What is the treatment for primary HSV infection in pregnancy
Oral acyclovir for 5 days
IV if disseminated
Aciclovir daily from 36 weeks to avoid active lesions at term
LSCS if active lesions at delivery or primary infection within 6 weeks
Describe management
Primary HSV within last 6 weeks, presents with SROM
Advise LSCS if SROM <4hr
If >4hr may still benefit so offer
Describe management
Primary HSV within 6 weeks, declining LSCS
IV aciclovir intrapartum
Avoid invasive procedures
Risk of neonatal infection 41%, unclear if acyclovir reduces risk
Describe management
Primary HSV within 6 weeks, PROM < 37 weeks
MDT decision
If immediate delivery - emcs
If conservative - IV aciclovir 8 hourly
I deliver within 6 weeks consider LSCS
Describe management
Recurrent HSV PROM < 34 weeks
Expectant management
Aciclovir 400mg tds
Describe management
Recurrent HSV PROM >34 weeks
Manage as per routine guidance - consider IOL from 34 weeks and off from 37
Describe management
Primary HSV within 6 weeks and NVD
Swabs
Empirical aciclovir
Breast feed unless nipple lesions
