Maternal Herpes Infection Complicated by Prolonged Premature Rupture of Membranes

Ray, Deborah A.; Evans, Arthur T.; Elliott, John P.; Freeman, Roger K.

doi:10.1055/s-2007-999923

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…That study also indicated the increased risk of premature delivery in women with primary infections compared with those with recurrent outbreaks. 1 In this case, as in the case published by Ray et al, 3 ruptured membranes had been present more than 4 hours prior to discovery of the lesion.…”

Section: Discussionsupporting

confidence: 55%

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Acyclovir Treatment of Primary Herpes in Pregnancy Complicated by Second Trimester Preterm Premature Rupture of Membranes with Term Delivery: Case Report

Dietrich

Napolitano²

2002

Am J Perinatol

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Primary genital herpes simplex virus (HSV) infection in pregnancy is associated with an increased risk of vertical transmission to the fetus, especially with rupture of membranes. Two cases of primary herpes and two cases of recurrent herpes in pregnancy with preterm premature rupture of membranes and expectant management have been reported, all delivering preterm. We report a case of primary maternal genital HSV infection with preterm premature rupture of membranes at 24 weeks' gestation who subsequently went on to deliver at term. This case was managed with intravenous acyclovir. Neonatal serology for HSV I (immunoglobulin M [IgM] and IgG) and HSV II (IgM) were negative. Antibodies for HSV II (IgG) were positive. Subsequent 6-month follow-up titers were negative for all herpes antibodies. On the basis of an extensive search of the English literature from 1966 to 2001, this is the first reported case of primary herpes in pregnancy associated with preterm premature rupture of membranes with a subsequent term delivery.

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Section: Discussionsupporting

confidence: 55%

“…None of these patients had reseal of membranes and all delivered prematurely. 3 The second case report in the literature describes a pregnancy complicated by ruptured membranes at 25.5 weeks with primary herpes infection managed by acyclovir. The infant delivered prematurely but never showed evidence of a herpetic infection.…”

Section: Discussionmentioning

confidence: 99%

Acyclovir Treatment of Primary Herpes in Pregnancy Complicated by Second Trimester Preterm Premature Rupture of Membranes with Term Delivery: Case Report

Dietrich

Napolitano²

2002

Am J Perinatol

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“…The literature on this topic is limited. Ray et al describes a case where amniocentesis on intact membranes returned positive for HSV and this resulted in a caesarean with the fetus unaffected [ 12 ], suggesting that fetal infection is more complex than just the presence of HSV in the intrauterine compartment. In the setting of unavoidable vaginal delivery in primary HSV, the risk of transmission and subsequent neonatal HSV is 41% [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks’ Gestation

Dalton

Grivell

2015

Case Reports in Obstetrics and Gynecology

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Background. Disseminated herpes simplex virus (HSV) in the neonate is associated with significant morbidity and mortality. Current guidelines recommend caesarean in third-trimester maternal primary genital HSV outbreaks to prevent transmission from mother to fetus. In the premature fetus, however, expectant management is often necessary to reduce morbidity of prematurity. The benefit of performing caesarean after 6 hrs of rupture of membranes (ROM) to reduce maternal-fetal transmission is unclear. Case. A female patient with primary genital HSV type 1 outbreak coinciding with preterm, prelabour rupture of membranes (PPROM) at 30 + 3 weeks' gestation. An immediate caesarean section was not performed after multidisciplinary team discussion due to the benefits of glucocorticoids on immune complications of prematurity. The patient had expectant management for 5 days with intravenous (IV) aciclovir and then delivered an infant vaginally with disseminated neonatal HSV. Conclusion. We address the rare presentation of primary HSV infection associated with PPROM and the dilemma of how to manage these patients given the limited literature. We discuss the role of intrauterine compartment monitoring with amniocentesis, the mode of delivery when ROM has occurred for 120 hours, expectant management to reduce prematurity, and the effectiveness of aciclovir to reduce viral shedding in the prevention of neonatal HSV.

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Maternal Infections, Human Immunodeficiency Virus Infection, and Sexually Transmitted Diseases in Pregnancy

Sweet

Minkoff

2007

Clinical Obstetrics

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Maternal Herpes Infection Complicated by Prolonged Premature Rupture of Membranes

Cited by 10 publications

References 8 publications

Acyclovir Treatment of Primary Herpes in Pregnancy Complicated by Second Trimester Preterm Premature Rupture of Membranes with Term Delivery: Case Report

Acyclovir Treatment of Primary Herpes in Pregnancy Complicated by Second Trimester Preterm Premature Rupture of Membranes with Term Delivery: Case Report

Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks’ Gestation

Maternal Infections, Human Immunodeficiency Virus Infection, and Sexually Transmitted Diseases in Pregnancy

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