Sananès N
Service de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, BP 426, 67091 Strasbourg cedex, France; Unité Inserm UMR-S 1121 « Biomatériaux et Bioingénierie », 11, rue Humann, 67000 Strasbourg, France.
Gynecol Obstet Fertil Senol. 2017 Dec;45(12):664-676. doi: 10.1016/j.gofs.2017.10.006. Epub 2017 Nov 11.
To provide guidelines for the management of first episode genital herpes during pregnancy and in the immediate postpartum period.
MedLine and Cochrane Library databases search and review of the main foreign guidelines.
In case of first episode genital herpes during pregnancy, antiviral treatment with acyclovir (200mg 5 times daily) or valacyclovir (1000mg twice daily) for 5 to 10 days is recommended (grade C). The patient should be tested for HIV if not previously done (grade B). Daily suppressive antiviral treatment with acyclovir (400mg 3 times daily) or valacyclovir (500mg twice daily) is recommended from 36 weeks for women who have had a first episode genital herpes during pregnancy (grade B). A cesarean section should be performed in case of suspicion of first episode genital herpes at the onset of labor (grade B) or premature rupture of the membranes at term (professional consensus), or in case of first episode genital herpes less than 6 weeks before delivery (professional consensus). In the event of first episode genital herpes highlighted in the postpartum period, the neonatologist should be informed (professional consensus). The patient may be treated according the scheme described above.
A cesarean section should be performed in case of first episode genital herpes less than 6 weeks before delivery.
为孕期及产后即刻首次发作的生殖器疱疹的管理提供指南。
检索MedLine和Cochrane图书馆数据库并查阅主要国外指南。
孕期首次发作生殖器疱疹时，推荐使用阿昔洛韦（200mg，每日5次）或伐昔洛韦（1000mg，每日2次）进行抗病毒治疗5至10天（C级）。若此前未检测，应对患者进行HIV检测（B级）。对于孕期首次发作生殖器疱疹的女性，建议从孕36周起每日使用阿昔洛韦（400mg，每日3次）或伐昔洛韦（500mg，每日2次）进行抑制性抗病毒治疗（B级）。若临产前怀疑首次发作生殖器疱疹（B级）、足月胎膜早破（专业共识）或分娩前不到6周首次发作生殖器疱疹（专业共识），应行剖宫产。若产后发现首次发作生殖器疱疹，应通知新生儿科医生（专业共识）。患者可按上述方案治疗。
分娩前不到6周首次发作生殖器疱疹时应行剖宫产。
