congenital herpes infection

congenital herpes infection - detection and management

1. GenitalHerpes
PerinatalHerpesenfeksiyonu
Dr. Tevfik YoldemirBScMSc
Marmara Üniversitesi Tıp Fakültesi
www.yoldemir.com

2. Rates of seroprevalenceand seroconversionof HSV in
pregnancy
OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10

3. Classification of genital HSV infections
OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10
ClinicalDesignationDescription
PrimarygenitalHSVNewly acquired antibodies to
infectionHSV 1or 2 in the absence of any
preexistingantibodies
Nonprimaryfirst-episodeNewly acquired antibodies to
genitalHSV infectionHSV 1or 2 in the presence of
preexistingantibodies to the
other type
RecurrentgenitalHSVReactivation of genital HSV with
infectionHSVtype recovered from lesion
sameas serum HSV type

4. Diagnosis
OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10
•Serologictesting (both IgGand IgM)
(+)
•viral identificationby culture,
•polymerase chain reaction(PCR),
•or direct antibody fluorescence to identify thecategory and
subtype of HSV infection

5. Methodsof diagnosingHSV
OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10

6. RecommendedtreatmentregimensforHSV
outbreaksin pregnancy
OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10
Both valacyclovirand acyclovir areconsidered safe for breast-feeding women

7. OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10

8. OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10

9. OBSTETRICAL AND GYNECOLOGICAL SURVEY 2011; Volume66, Number10
HSV endometritiscan be confirmed with an
endometrial biopsyforPCR orculture

10. Risk factors
Am FamPhysician. 2016;93(11):928-934.

11. Differentialdiagnosisof genitalulcers
Am FamPhysician. 2016;93(11):928-934.

12. ScenariostoconsiderHSV Type-Specific
SerologicTesting
Am FamPhysician. 2016;93(11):928-934.

13. SOGC Recommendations
J Obstet Gynaecol Can 2017;39(8):e199ee205
1. Women’s history of genital herpes should be evaluated early
inpregnancy(III-A).
2. Women with known recurrent genital herpes simplex virus
(HSV)should be counselledabout the risks of transmission of
HSV to theirneonatesat delivery(III-A).
3. At delivery, women with recurrent HSV should be offered a
Caesarean section if there are prodromalsymptoms or in the
presence of a lesion suggestive of HSV (II-2A).
4. Women with known recurrent genital HSV infection should be
offered acyclovir or valacyclovirsuppression at 36 weeks’
gestationto decrease the risk of clinical lesions and viral
shedding at the timeof delivery and therefore decrease the
need for Caesareansection(I-A).

14. SOGC Recommendations
J Obstet Gynaecol Can 2017;39(8):e199ee205
5. Women with primary genital herpes in the third trimester of
pregnancyhave a high risk of transmitting HSV to their
neonates andshould be counselledaccordingly and should be
offered aCaesarean section to decrease this risk (II-3B).
6. A pregnant woman who does not have a history of HSV but
whohas had a partner with genital HSV should have type-
specificserology testing to determine her risk of acquiring
genital HSVin pregnancy before pregnancy or as early in
pregnancy aspossible. Testing should be repeated at 32 to 34
weeks’ gestation(III-B).

15. DirectmethodsforHSV diagnosis
VirologyJournal2009, 6:40

16. VirologyJournal2009, 6:40

17. IndirectmethodsforHSV diagnosis
VirologyJournal2009, 6:40

18. Modeof delivery
VirologyJournal2009, 6:40

19. Modeof delivery
VirologyJournal2009, 6:40

20. Various dietary phytochemicals with chemical structure
and role in general cancers andtransplacentalmodels

21. Maternal and fetal risks in viral infections
Clinicsin Dermatology(2016) 34, 368–377

22. Thankyouforyourattention.
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