title: Clinical practice in prevention of neonatal HSV infection: a survey of obstetrical care providers in Alberta.
abstract: OBJECTIVE
  To identify the current practice patterns of physicians providing prenatal care in Alberta with respect to prevention of neonatal herpes simplex virus (HSV) infection.
  
  
  METHODS
  A 22-item questionnaire was mailed to all obstetricians and family physicians providing obstetrical care in Alberta. The questionnaire included demographic and practice details, and details of management of patients with a history or symptoms of HSV lesions, including practice in prescribing antiviral therapy, recommending elective Caesarean section, and ordering serology. Two reminders were mailed as necessary.
  
  
  RESULTS
  Responses were received from 89 obstetricians (57%) and 94 family physicians (54%). Antiviral therapy was prescribed for the prevention of neonatal HSV infection in the third trimester by 97% of obstetricians versus 84% of family physicians (P = 0.007), with acyclovir being the most commonly prescribed agent. Caesarean section was offered "most of the time" to women with primary HSV infection in the third trimester by 65% of physicians, to women with prodromal symptoms during the intrapartum period by 57% (no significant differences between groups), and to women with HSV lesions by 92% of obstetricians and 82% of family physicians (P = 0.032). Women with a negative HSV history but whose partner had known HSV were offered serological testing "most of the time" by 30% of physicians (no significant difference between groups).
  
  
  CONCLUSIONS
  Despite the encouraging survey results, obstetrical providers should be encouraged to offer Caesarean section to women with a primary HSV infection in the third trimester and to offer serological testing in discordant couples. These simple strategies can help to prevent neonatal HSV infection and its long-term consequences.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Kenny
authors.affiliation: Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB.
authors.forename: Wynne
authors.initials: W
authors.lastname: Leung
authors.affiliation: Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB.
authors.forename: Kirk
authors.initials: K
authors.lastname: Stephanson
authors.affiliation: Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB; Departments of Family Medicine, Community Health Sciences, and Surgery, University of Calgary, Calgary AB.
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000416:Alberta; D000998:Antiviral Agents / Q000627:therapeutic use; D002585:Cesarean Section; D005194:Family Practice; D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care; D012747:Sexual Partners; D011795:Surveys and Questionnaires
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir