CTF Summary Table: Neonatal Herpes Simplex

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Prevention of Neonatal Herpes Simplex

Prepared by Elaine E.L. Wang, MD, CM, FRCPC, Department of Pediatrics, University of Toronto

These recommendations were finalized by the Task Force in February 1989

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Recurrent infection: Weekly screening (starting at 32 weeks' gestation); cesarean section among women with positive culture results or findings at clinical examination. Identification and screening of pregnant women at risk of recurrent infection has not been shown to prevent neonatal death and illness from infection. Screening trial and prospective cohort study <1-4> (II-2) Fair evidence to exclude from routine prepartum care in high-risk pregnancies.* (D)

Symptomatic infection: Clinical examination; cesarean section among women with positive findings at clinical examination. Transmission of herpes simplex to newborn can be prevented among women with clinical evidence of genital herpes simplex at delivery. Expert opinion <5,7> (III) Poor evidence to include cesarean section in or exclude it from routine prepartum care of symptomatic women. (C)

* Women at high risk are those with a history of recurrent herpes simplex or active disease during current pregnancy and those whose sexual partner has proven genital herpes simplex.

Link to Full Text of this review

Link to Structured Abstract of this review

Link to Selected References list of this review

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Recurrent infection: Weekly screening (starting at 32 weeks' gestation); cesarean section among women with positive culture results or findings at clinical examination.	Identification and screening of pregnant women at risk of recurrent infection has not been shown to prevent neonatal death and illness from infection.	Screening trial and prospective cohort study <1-4> (II-2)	Fair evidence to exclude from routine prepartum care in high-risk pregnancies.* (D)
Symptomatic infection: Clinical examination; cesarean section among women with positive findings at clinical examination.	Transmission of herpes simplex to newborn can be prevented among women with clinical evidence of genital herpes simplex at delivery.	Expert opinion <5,7> (III)	Poor evidence to include cesarean section in or exclude it from routine prepartum care of symptomatic women. (C)