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| |  Herpes Simplex Virus Remains a Rare But Important Cause of Perinatal Mortality: Presented at ASCP By Lexa W. Lee NEW ORLEANS, LA -- October 25, 2007 -- Universal prenatal screening for herpes simplex virus (HSV) may be indicated, according to new findings presented hereat the annual meeting of the American Society of Clinical Pathology (ASCP). Genital herpes infections are epidemic in the United States. The virus is also a rare but significant cause of perinatal morbidity and mortality, usually acquired through maternal secretions during vaginal delivery. Although neonatal herpes is not a reportable disease, incidence has only been estimated, with figures between 0.02% and 0.06% (1 in 1,500-3,500 live births), depending on the location. Intrauterine transmission, primarily via ascending route infection, can be a cause. Even if treated, the infant may suffer brain damage. Prenatal screening for HSV is not standard in most areas, and management guidelines rely on an accompanying history of maternal HSV infection, which is often lacking. In addition, many pregnant women infected with HSV are seronegative. Researchers led by Meiklejohn McKenzie, MD, Resident Pathologist, University of Alabama at Birmingham, Birmingham, Alabama, United States, conducted a retrospectively study to evaluate the prevalence of perinatal HSV infection at their institution. They examined the charts for perinatal autopsies that were performed over a period of 15 years. Of the total sample of 749 infants, 56% were stillborn. HSV infection was identified in 1.06% (8) of the total sample. Among these infants, the average gestational age was 32.3 weeks, and all had disseminated HSV. Six of this group were live born. Seven infants were delivered vaginally; three of these births followed prolonged rupture of membranes. One was delivered by Caesarean section, also after prolonged rupture of membranes. Based on clinical records, placental reports, and autopsy findings, three showed evidence of intrauterine infection prior to labour and delivery, four were infected intrapartum, and one postnatally. Among the six live born, three were clinically suspected of being infected. Dr. McKenzie said, "Our study findings show that herpes viral infection remains a rare but important cause of perinatal mortality. Its risk is often underappreciated, suggesting that universal prenatal screening for HSV should be considered."
[Presentation title: Perinatal Herpes Simplex Virus: A Fifteen Year Autopsy Review. Poster 58]
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