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Old 08-09-2013
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Default OB/GYN question #7

A 25 y/o primigraiv woman at 39 weeks gestation comes to the clinic because the felt a gush of water in her vagina. You notice in her chart that she had an outbreak of genital herpes at 34 weeks gestation. A sterile speculum examination shows a pool of fluid in the vagina that is nitrazine positive. Examination also demonstrates an ulcerated lesion in the anterior lip of the cervix and an ulcerated lesion in the posterior wall of the vagina. She also says that since yesterday she has felt tingling in her genital area. At this time the most correct statement about her would be.
A. The fetus is already infected.
B. The lesion is not infectious.
C. SHe should be sent home.
D. She should be started on Oxytocin immediately,
E. She should have a C-Section
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Old 08-09-2013
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Originally Posted by XpaezX View Post
A 25 y/o primigraiv woman at 39 weeks gestation comes to the clinic because the felt a gush of water in her vagina. You notice in her chart that she had an outbreak of genital herpes at 34 weeks gestation. A sterile speculum examination shows a pool of fluid in the vagina that is nitrazine positive. Examination also demonstrates an ulcerated lesion in the anterior lip of the cervix and an ulcerated lesion in the posterior wall of the vagina. She also says that since yesterday she has felt tingling in her genital area. At this time the most correct statement about her would be.
A. The fetus is already infected.
B. The lesion is not infectious.
C. SHe should be sent home.
D. She should be started on Oxytocin immediately,
E. She should have a C-Section
active herpes infection so i think she should have a c section. I dont know whether the baby gets infected with her starting labor already.
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Old 08-09-2013
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E... think the baby only gets infected by direct contact with active herpes lesions when passing thru birth canal...
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Old 08-09-2013
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proceed with C section
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Matched!!!
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Old 08-10-2013
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The correct answer is E. She should have a C-section. This patient has a past medical history of active herpetic lesions and right now is presenting in labor with 2 suspicious lesions.. Telling the patient that the fetus is already infected is incorrect because Herpes Simplex viruses dont cross the placenta that easily even if the woman has multiple infection throughout her pregnancy. The current recommendations is to perform a C section in a woman with active suspicious lesions because this has shown to decrease the risk of fetal herpes by a lot. Remember neonatal Herpes simplex can basically destroy the newborn so bad is not even funny.

Good job everybody!
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