The incidence of herpes simplex virus labialis after cesarean delivery

Norris, Mark C.; Weiss, Jeffrey A.; Carney, Megan; Leighton, Barbara L.

doi:10.1016/0959-289x(94)90223-2

Cited by 13 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21,22 This association, however, has not been confirmed by others and remains controversial. 23 It is noteworthy that no such association has been reported between neuraxial opioids and recurrence of HSV type-2 infections.…”

Section: Anesthetic Implicationsmentioning

confidence: 98%

The febrile parturient: choice of anesthesia

Kuczkowski

2002

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

The febrile parturient: choice of anesthesia ture and temperature control mechanisms that constantly adjust body temperature, to maintain this level. Fever is defined as an increase in core body temperature above 38 ºC, which is secondary to an increase in the hypothalamic set point. 1, 3 The human body temperature rarely exceeds 41ºC. Normal circadian fluctuation in body temperature with increase in the evening and decrease in the morning continues even in febrile patients. 4 Under normal circumstances, core body temperature is tightly regulated, with a variation of approximately 0.5ºC. While it is uncertain as to the benefits of fever, there are suggestions that the increased body temperature aids in the activation of the host immune response with augmentation of bactericidal, phagocytic and chemotactic properties of polymorphonuclear leukocytes. The negative aspects of fever include increased basal metabolic rate and increased cardiac demand. FEVER: INTERACTION WITH PREGNANCYPhysiologic changes of pregnancy include an increase in the maternal basal metabolic rate. 5 Maternal body temperature in labor is also significantly affected by the degree of physical activity and intensity of uterine contractions. Pain associ- INTRODUCTION Fever is a common clinical problem in labor and delivery suites -worldwide. The febrile parturient presents a unique diagnostic dilemma and therapeutic challenge to both an obstetrician and an anesthesiologist involved in her care. Fever can result from a variety of infectious microorganisms, tissue trauma, malignancy, drug administration, endocrine and immunological disorders. However, infection is by far the most common cause of fever in the parturient. 1, 2 The infectious etiology of fever in a parturient may be pregnancy specific, such as chorioamnionitis, or not specific to pregnancy, such as urinary tract infection. The risk to the mother and the fetus is significantly increased in pregnancy complicated by infection and fever. The diverse clinical manifestations of various infectious disorders combined with the unique anesthetic implications of pregnancy may result in life-threatening complications and significantly impact upon the practice of obstetric anesthesia.The diagnosis of infection in pregnancy often raises questions about the safety of neuraxial anesthesia in febrile patients. Despite this concern, and lack of universal guidelines, it has now been well established that the presence of infection and fever in labor does not always contraindicate the administration of regional anesthesia. 2 The decision whether to administer regional anesthesia or not in a febrile parturient should be based on an individual risk-to-benefit ratio.

show abstract

Section: Anesthetic Implicationsmentioning

confidence: 98%

The febrile parturient: choice of anesthesia

Kuczkowski

2002

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

show abstract

“…The dose of epidural morphine used in the Boyle trial was not reported. 28 In contrast to previous findings, Norris et al 29 found no increased incidence of herpes labialis in women receiving neuraxial morphine compared with systemic analgesia. However, the majority of patients in the neuraxial morphine group received spinal morphine.…”

Section: Hsv Reactivation After Neuraxial Morphine For Cesarean Delivmentioning

confidence: 94%

“…28 Both trials using intrathecal morphine for postcesarean delivery analgesia demonstrated more frequent and severe pruritus in the intrathecal group, but there was no association between pruritus and HSV reactivation after correcting for a history of herpes labialis. 29,30 Given the lack of evidence that pruritus is the mechanism by which HSV is reactivated in women receiving neuraxial morphine for postcesarean analgesia, recommendations for avoidance of facial scratching or aggressive treatment of pruritus cannot be advocated except for maternal comfort.…”

Section: Postulated Mechanisms For Hsv Reactivation With Neuraxial Momentioning

confidence: 99%

Neuraxial Morphine and Oral Herpes Reactivation in the Obstetric Population

Bauchat

2010

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

Neuraxial morphine administration is a common strategy for providing postcesarean delivery analgesia. Morphine delivered via this route increases the risk of herpes labialis (oral herpes) reactivation, a disease common in women of childbearing age. A primary concern is risk of transmission to the neonate from maternal reactivation. The benefits to the mother of this form of analgesia outweigh the risk of neonatal herpes acquired postpartum from maternal recurrence because serious neonatal morbidity from recurrent herpes has not been described.

show abstract

“…Reactivation occurs when the virus is transported in a retrograde manor, from within latently infected neurons, down the axon, to the peripheral site of the original primary infection 8. Reactivation may occur due to stressors such as heat, cold, infection, trauma, emotional stress, and especially, immunosuppression 9 10. Symptoms during reactivation tend to be milder with prodromal tingling, pruritus and pain around the primary infection site.…”

Section: Introductionmentioning

confidence: 99%

“…Reported HSV-1 reactivation rates varied between 3.5% and 38% 2–4 6 7. However, one prospective study specifically investigated the risk of oral herpes lesions in 357 parturients after elective or emergent cesarean delivery and reported a trend suggesting the increased presence of facial lesions in women who received intrathecal morphine, without statistical significance 9. There are no trials that show an increased risk of HSV reactivation after other neuraxial opioids 7.…”

Section: Introductionmentioning

confidence: 99%

Pruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients

Putte

Jahr

Gieraerts

et al. 2022

Reg Anesth Pain Med

View full text Add to dashboard Cite

Neuraxial opioids are well known to cause itching, which may be challenging to treat. Neuraxial morphine has been demonstrated to cause recrudescent herpes simplex viruses (HSV-1), especially in women during labor and childbirth with neuraxial analgesia, and may be an occult etiology of refractory itching. This educational review summaries the clinical and epidemiological characteristics associated with recrudescent HSV-1 in patients treated with neuraxial opioids, especially morphine

show abstract

The incidence of herpes simplex virus labialis after cesarean delivery

Cited by 13 publications

References 10 publications

The febrile parturient: choice of anesthesia

The febrile parturient: choice of anesthesia

Neuraxial Morphine and Oral Herpes Reactivation in the Obstetric Population

Pruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients

Contact Info

Product

Resources

About