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APHA Scientific Session and Event Listing

Recorded presentation

Zane A. Brown, MD, University of Washington, Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Box 356460, Seattle, WA 98195, 206-543-3714, zbrown@u.washington.edu

More than 20 percent of pregnant women have genital herpes prior to conception, and another 2% will acquire genital herpes during pregnancy. These women are at risk of transmitting HSV to their newborn late in pregnancy and during labor and delivery. Transmission risk is highest for women with primary (50%) or first episode (30%) herpes infection, but is 1-3% with recurrent infection. Incidence estimates range from 1/2000 to 1/5000 live births; accurate data and trends are not available since the infection is not reportable in most states and there is no single specific code for neonatal herpes in the International Classification of Diseases (ICD). Neonatal herpes infection results in variable clinical presentations, many of which are extremely severe; establishing the diagnosis is often difficult, and may be delayed. Infants with disseminated herpes have a mortality >50% even with treatment, and >85% of survivors have neurological sequelae, often severe. Reducing risk of transmission to neonates should be a high priority for obstetricians. Type specific serological testing early in pregnancy identifies HSV infected women and those at risk, and allows for counseling and risk reduction steps. Other considerations include antiviral suppressive therapy in the month prior to delivery, avoiding invasive procedures intrapartum if possible, and recommending cesarean delivery for women with genital lesions during labor.

Learning Objectives:

• See session abstract

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Organization	Clinical/Research Area	Type of Relationship
Glaxo-Smith Klein, Inc	Speaker's Bureau	Speaker's bureau and teaching engagements

Any company-sponsored training?	No
Any institutionally-contracted trials related to this submission?	No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Recorded presentation