Julie van Schalkwyk1, Neda Amiri1, Sayrin Lalji1, Carolyn Gardella2, Anna Wald3, Deborah Money1. 1. Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of British Columbia, Vancouver BC. 2. Department of Obstetrics and Gynecology, University of Washington, Seattle WA. 3. Department of Medicine and Epidemiology, University of Washington, Seattle WA.
Abstract
OBJECTIVE: To determine the acceptability to pregnant women and their health care providers of a rapid test for genital herpes simplex virus (HSV) in labour. METHODS: A cross-sectional survey was conducted with outpatient pregnant women and their health care providers (obstetricians, family physicians and midwives) at BC Women's Hospital and Health Centre. RESULTS: Of pregnant women approached, 207 (92%) completed the survey; 90% reported no history of genital herpes. Rapid HSV testing in labour was acceptable to 85% of pregnant women. Among the 133 women who were planning a vaginal delivery, 63% were willing to consider delivery by Caesarean section and 53% were willing to consider intrapartum anti-viral medications if HSV was present in the genital tract. Of 51 health care providers surveyed, 98% indicated interest in knowing if their patient had a newly acquired HSV infection, while 84% indicated interest in knowing if the patient had a reactivation of infection. If HSV was detected in their patient's genital tract, 36% indicated they would recommend a Caesarean section, and 25% would consider antiviral medication as an investigational intrapartum treatment. Interestingly, both of these proportions increased if the patient had ruptured membranes for more than four hours. CONCLUSION: Most pregnant women and their health care providers are receptive to the use of a rapid polymerase chain reaction test to detect genital HSV shedding in labour. This supports the development of HSV rapid testing and antiviral therapy trials in the labour setting.
OBJECTIVE: To determine the acceptability to pregnant women and their health care providers of a rapid test for genital herpes simplex virus (HSV) in labour. METHODS: A cross-sectional survey was conducted with outpatient pregnant women and their health care providers (obstetricians, family physicians and midwives) at BC Women's Hospital and Health Centre. RESULTS: Of pregnant women approached, 207 (92%) completed the survey; 90% reported no history of genital herpes. Rapid HSV testing in labour was acceptable to 85% of pregnant women. Among the 133 women who were planning a vaginal delivery, 63% were willing to consider delivery by Caesarean section and 53% were willing to consider intrapartum anti-viral medications if HSV was present in the genital tract. Of 51 health care providers surveyed, 98% indicated interest in knowing if their patient had a newly acquired HSV infection, while 84% indicated interest in knowing if the patient had a reactivation of infection. If HSV was detected in their patient's genital tract, 36% indicated they would recommend a Caesarean section, and 25% would consider antiviral medication as an investigational intrapartum treatment. Interestingly, both of these proportions increased if the patient had ruptured membranes for more than four hours. CONCLUSION: Most pregnant women and their health care providers are receptive to the use of a rapid polymerase chain reaction test to detect genital HSV shedding in labour. This supports the development of HSV rapid testing and antiviral therapy trials in the labour setting.