Progress on Herpes Testing during Pregnancy
Hello from snowy Michigan. As many of you know, I travel around the country, lecturing on genital herpes infection for about 10 days a month. This week I am in Michigan for the entire week, driving across the state from Kalamazoo to Jackson to Monroe to Detroit to Saginaw. I've had several lunches, breakfasts and dinners with physicians and nurse practitioners and nurse midwives and physician assistants, and here, have focused mostly on OB/GYN providers.
It has been gratifying to find many of these clinicians open to testing for herpes during pregnancy. You see, herpes testing is not a part of routine OB care in many parts of the country. The usual practice is to ASK patients, as they begin their OB care, "do you have herpes or does your partner have herpes?" But as those of you who read my posts know, 25% of the US population is infected with HSV 2 and 90% of those infected don't know. So ASKING misses 90% of those infected!
If we don't know who is infected with HSV 2, we cannot put them on suppressive therapy at 36 weeks, we cannot avoid the use of fetal scalp electrodes for monitoring fetal health (which disturbs intake skin and may allow virus to enter the baby's body), we might prematurely rupture membranes to speed labor (which also puts babies more at risk of HSV acquisition). All of these things could be avoided if we only knew the woman was infected!
In addition, if we did herpes testing on all pregnant women, we would know who was NOT infected and still vulnerable to infection. If we knew that, then we could advise an HSV negative woman to proceed in one of two ways: 1) she could have her sexual partner tested. If they are also negative for HSV, then sex could proceed normally. If her partner was positive for HSV 2 or had HSV 1 orally, then we could advise the couple, prior to the third trimester, about sexual behavior that is safe or not safe. or 2) she could simply avoid sexual contact during the third trimester, thus protecting her baby in that way. The WAY COOL thing is that I identified one OB doc who already tests all of his patients, another who is offering testing to all patients (I personally think it should not be optional but mandatory, as is gonorrhea and chlamydia testing), and another group of OB providers who was eager to hear about the testing protocol and was eager to implement it. Very exciting week in terms of openness to pregnancy testing!
Perhaps I will write you blogs from the backroads of America, taking the "herpes temperature" of US providers.
Stay warm, everybody, it's cold out there!
Terri
Related Topics: Herpes and Pregnancy, STD's and Pregnancy
It has been gratifying to find many of these clinicians open to testing for herpes during pregnancy. You see, herpes testing is not a part of routine OB care in many parts of the country. The usual practice is to ASK patients, as they begin their OB care, "do you have herpes or does your partner have herpes?" But as those of you who read my posts know, 25% of the US population is infected with HSV 2 and 90% of those infected don't know. So ASKING misses 90% of those infected!
If we don't know who is infected with HSV 2, we cannot put them on suppressive therapy at 36 weeks, we cannot avoid the use of fetal scalp electrodes for monitoring fetal health (which disturbs intake skin and may allow virus to enter the baby's body), we might prematurely rupture membranes to speed labor (which also puts babies more at risk of HSV acquisition). All of these things could be avoided if we only knew the woman was infected!
In addition, if we did herpes testing on all pregnant women, we would know who was NOT infected and still vulnerable to infection. If we knew that, then we could advise an HSV negative woman to proceed in one of two ways: 1) she could have her sexual partner tested. If they are also negative for HSV, then sex could proceed normally. If her partner was positive for HSV 2 or had HSV 1 orally, then we could advise the couple, prior to the third trimester, about sexual behavior that is safe or not safe. or 2) she could simply avoid sexual contact during the third trimester, thus protecting her baby in that way. The WAY COOL thing is that I identified one OB doc who already tests all of his patients, another who is offering testing to all patients (I personally think it should not be optional but mandatory, as is gonorrhea and chlamydia testing), and another group of OB providers who was eager to hear about the testing protocol and was eager to implement it. Very exciting week in terms of openness to pregnancy testing!
Perhaps I will write you blogs from the backroads of America, taking the "herpes temperature" of US providers.
Stay warm, everybody, it's cold out there!
Terri
Related Topics: Herpes and Pregnancy, STD's and Pregnancy
8 Comments:
Terri, I have some questions I really need answered. I was wondering if having g-herpes will stop me from becoming a nurse. Also,I have been feeling really depressed lately after my boyfriend who gave me herpes dumped me after almost 3 years. I dont like being single, I wanted to marry my boyfriend and become a mother some day down the line. but all that seems highly unlikely now. What guy is going to want to be with a girl he cannot make love to????I really need some answers and words of wisdom!!!!!
To the last poster. I too am hoping to become an RN.
I dont have Genital Herpes,...But my partner does. So I have some of the same concerns as you.
As too "what guy is going to want to be with a girl he cannot make love to????" comment.
Move foward & keep your head up. If someone really loves you for who you are, then that wont stop a real relationship.
I love my girl, she has genital herpes & I will be by my girl, whether we have protected sex, or none @ all!
I hope that one day she will marry me & maybe even become a mother as well.
She has many issues related to her infection, her fears & insecurities have almost caused me to give up, not her herpes.
I wish you luck in your voyage.
I need to find a ob doctor who delivers babies in the NYC tristate area for women with hsv2.My plan is ghi.thanks
Hi...My Gf of 11 months has herpes. She caught it like 20 years ago. She takes perscribed medication on a regular basis and told me of the condition prior to intercourse. I have not gotten anything from her as far as I can tell. We do have sex w/o a condom. Will I get herpes from unprotected sex if she is on meds?
I am 28 weeks pregnant.I have being aware I have genital herpes since 1998.I don't want to have a C-section and my GYN/OB has prescribed Valtrex 500mg once daily for a week, the week before delivery.Is this adequate to protect my baby girl? I have not had an outbreak in months and don't take medications regularly.Is this bad for me?
Thanks for your info & keep up the good work.
For those of you with questions about your specific situation, please visit our genital herpes message board.
Thanks!
Well for me its a little different I am only 18 and this is my 3rd year with gh. It bothers me because I am so young but I have found someone that excepts me and I am grateful!!!
Me and "him" have been having unpro sex for almost a year now and I have not had a period is the last 6 months when I went to the doctor she said I was not pregnant and the reason I have not gotten a period is because of my hormones. Well the last week or two my nipples have been very sore. Is it something I should look into, or is all hope gone. I know I am young but this is important to me. My doctor does not understand What do I do? Please help me!!!!
Is supressive therapy safe during pregnacy? Is it safer to be off during my pregnacy then go back on one week before delivery or just stay on daily?
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