Harger J H, Pazin G J, Armstrong J A, Breinig M C, Ho M
Am J Obstet Gynecol. 1983 Apr 1;145(7):784-91. doi: 10.1016/0002-9378(83)90679-8.
The natural history of genital herpes simplex virus (HSV) infections was investigated in 83 pregnancies in 78 women, and the information was used to determine the need for cesarean section in these women. We studied 163 recurrent episodes with HSV cultures from the cervix and from vulvar lesions every 1 to 3 days. Cervical HSV cultures were obtained weekly from asymptomatic women beginning at 32 weeks' gestation, and 14/462 (3.03%) of these cultures were positive. Cervical cultures obtained during culture-positive vulvar recurrences demonstrated concomitant cervical HSV shedding in 25/165 (15.2%) cultures. Mean duration of 26 genital HSV recurrences was 4.6 +/- 2.8 days with a range of 1 to 13 days. The mean interval between culture-positive HSV recurrences was 59.2 +/- 42.1 days, but many (14/76 = 18%) intervals were less than 21 days. Viral cultures were already positive in 92.3% of cases after 4 days' incubation, so they could be used effectively to determine route of delivery. Following a cautious set of criteria for vaginal delivery in these women, 69.1% were delivered of their infants vaginally and no neonatal morbidity caused by HSV was encountered. Information about the natural history of genital HSV infections obtained from frequent third-trimester viral cultures can be used to manage pregnancy and will reduce the need for cesarean section while avoiding neonatal HSV morbidity.
对78名女性的83次妊娠进行了单纯疱疹病毒（HSV）生殖器感染自然史的研究，并利用这些信息来确定这些女性是否需要剖宫产。我们每隔1至3天对宫颈和外阴病变进行HSV培养，共研究了163次复发情况。从妊娠32周开始，每周对无症状女性进行宫颈HSV培养，其中14/462（3.03%）的培养结果呈阳性。在培养阳性的外阴复发期间进行的宫颈培养显示，25/165（15.2%）的培养结果显示宫颈同时存在HSV脱落。26次生殖器HSV复发的平均持续时间为4.6±2.8天，范围为1至13天。培养阳性的HSV复发之间的平均间隔为59.2±42.1天，但许多间隔（14/76 = 18%）小于21天。病毒培养在孵育4天后，92.3%的病例已呈阳性，因此可有效用于确定分娩方式。按照对这些女性进行阴道分娩的谨慎标准，69.1%的婴儿通过阴道分娩，未出现由HSV引起的新生儿发病情况。从孕晚期频繁进行的病毒培养中获得的关于生殖器HSV感染自然史的信息可用于管理妊娠，并将减少剖宫产的需求，同时避免新生儿HSV发病。
