Pharmacokinetics of acyclovir in the term pregnancy and neonate
Article Abstract:
As many as half of all pregnant women with histories of recurrent genital infections with herpes simplex virus (HSV) undergo cesarean section, a procedure that carries its own risks and high costs. This is done to prevent transmission of HSV infection to the infants, who are at risk from infected cervical and vulvar cells that may be shed just before or during delivery. Acyclovir is a safe, effective agent for treating HSV infections in nonpregnant women, but it has not been evaluated in pregnant women. To learn more concerning this issue, 14 pregnant women with histories of genital HSV type 21 infection were studied during 15 pregnancies. They were given acyclovir at one of two doses (200 or 400 milligrams) every eight hours, beginning at 38 weeks' gestation, until delivery. Blood was sampled to determine acyclovir concentrations and HSV cultures were taken biweekly to evaluate the presence of HSV infection. The concentration of acyclovir was measured in maternal and infant blood at delivery and at regular intervals thereafter for the first two days. Follow-up examinations were carried out for mothers and their children for the next six months. Results showed that the drug was not associated with adverse effects in the mothers, and the infants appeared normal at birth. Blood tests on the infants revealed no abnormalities. HSV infection or viral shedding were not noted in 14 of the pregnancies. The pharmacokinetics of acyclovir are presented. The drug was concentrated in amniotic fluid (in which the fetus floats), probably as a result of excretion in fetal urine; however, it did not accumulate in the fetuses. No signs of acyclovir toxicity in the fetuses were observed. This drug has been given to newborns for more than 10 years, without apparent long-term consequences. While the results offer a possible way for HSV-infected mothers to avoid cesarean delivery, additional research concerning the safety and effectiveness of oral acyclovir in pregnancy needs to be carried out. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1991
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A comparison between detailed and simple histories in the diagnosis of genital herpes complicating pregnancy
Article Abstract:
A detailed history of genital symptoms does not appear to accurately identify cases of genital herpes in pregnant women. An active herpes infection can be transmitted to the baby at birth with potentially life-threatening results. Researchers asked a group of 201 pregnant women in-depth questions about genital symptoms suggestive of herpes as well as whether they had ever had herpes. Of these women, 177 gave no history suggestive of herpes, but 30.4% of the group with a negative history had a positive blood test for herpes virus. Conversely, only 50% of the 18 women giving histories of symptoms highly suggestive of herpes tested positive for the virus.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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A double-blind, randomized, placebo-controlled trial of acyclovir in late pregnancy for the reduction of herpes simplex virus shedding and cesarean delivery
Article Abstract:
Research has been conducted on the role of acyclovir in herpes simplex virus culture reduction and polymerase chain reaction positivity and cesarian delivery. They report that acyclovir can reduce but not eliminate herpes simplex virus lesions during late pregnancy.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 2003
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