Prevention of and screening for herpes simplex infection: a survey of Quebec physicians

To determine which methods are most used by Quebec physicians performing deliveries with regard to the prevention of and screening for infections caused by the herpes simplex virus.

A pretested bilingual questionnaire was mailed to all the general practitioners performing deliveries who belong to the Association des omnipraticiens en périnatalité du Québec, as well as to all obstetrician-gynaecologists belonging to the Association of Obstetricians and Gynecologists of Quebec, with two follow-up reminder communications. The participants' anonymity was maintained.

Of the 877 questionnaires sent, 539 (62%) were completed and returned; 451 participants (84% of the total) met the selection criteria. The majority (92%) of physicians performing deliveries asked pregnant women if they had a history of genital herpes. To prevent primary genital herpes, 73% of physicians recommended using condoms, 42.5% recommended abstinence when lesions are present, 33% recommended that the partner be given an antiviral treatment, and 3.3 % did not provide any specific advice. For a woman who presents with a confirmed history of genital herpes, vaginal delivery was preferred in (1) 87.5% of cases when the infection did not recur during pregnancy, (2) 94% of cases when the infection recurred before the third trimester, (3) 98% of cases when the infection recurred during the third trimester and an antiviral treatment was provided. In the case of a pregnant woman at term with herpetic lesions and with ruptured membranes, Caesarean section was preferred by 79% of obstetricians and 95% of general practitioners (P < 0.001).

The screening and prevention methods preferred by most Quebec physicians performing deliveries match the recommendations of the current clinical practice guidelines.