Acyclovir Prophylaxis in Late Pregnancy to Prevent Neonatal Herpes: A Cost-Effectiveness Analysis

Randolph, Adrienne G.; Rm, Hartshorn; Ae, Washington

doi:10.1016/0029-7844(96)00261-x

Cited by 64 publications

(19 citation statements)

References 30 publications

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“…In addition, no infant in these studies acquired neonatal herpes, although the sample size cannot preclude a small failure rate [18,[28][29][30][31]. The dosages in these studies were acyclovir 400 mg, taken orally three times a day, or acyclovir 200 mg, taken four times a day, from 36 weeks until delivery.…”

Section: Maternal Recurrent Hsv In Pregnancymentioning

confidence: 97%

Guidelines for the management of herpes simplex virus in pregnancy

2008

Intl J Gynecology & Obste

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Section: Maternal Recurrent Hsv In Pregnancymentioning

confidence: 97%

Guidelines for the management of herpes simplex virus in pregnancy

2008

Intl J Gynecology & Obste

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“…Furthermore, women with recurrent infections who are shedding virus at the time of delivery are at low risk of their babies developing neonatal HSV disease (21,23,24,28,62), as discussed above. Decision analyses estimate that 1,580 excess cesarean section deliveries are performed for every poor neonatal outcome prevented, 0.57 maternal death occurs for every neonatal death prevented, and an estimated $2.5 million is spent for every neonatal case averted by this approach (71,72). These figures contrast with ones regarding cesarean deliveries for women with no history of genital herpes, which result in only nine excess cesarean deliveries per poor neonatal outcome prevented and 0.004 maternal death for every neonatal death prevented.…”

Section: Prevention Cesarean Deliverymentioning

confidence: 99%

Neonatal Herpes Simplex Infection

2004

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Tremendous advances have occurred over the past 30 years in the diagnosis and management of neonatal herpes simplex virus (HSV) disease. Mortality in patients with disseminated disease has decreased from 85 to 29%, and that in patients with central nervous system (CNS) disease has decreased from 50 to 4%. Morbidity has been improved more modestly: the proportion of patients with disseminated disease who are developing normally at 1 year has increased from 50 to 83%. While the proportion of patients with neurologic morbidity following CNS disease has remained essentially unchanged over the past three decades, the total number of patients who are developing normally following HSV CNS disease has increased due to the improved survival. Although additional therapeutic advances in the future are possible, more immediate methods for further improvements in outcome for patients with this potentially devastating disease lie in an enhanced awareness of neonatal HSV infection and disease. A thorough understanding of the biology and natural history of HSV in the gravid woman and the neonate provides the basis for such an index of suspicion and is provided in this article

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“…When Randolph et al attempted to determine whether using acyclovir prophylaxis in late pregnancy to prevent neonatal herpes infection was cost-effective, they chose the number of infants with either neurodevelopmental disability or death as a measure of effectiveness (21). The choice of an explicit health state as a measure of effectiveness often can simplify the analysis, because the health state can be easily defined and can be derived from the basic probabilities that must be used within the decision tree.…”

Section: What Are the Inputs Into A Decision Analysis And Where Do Thmentioning

confidence: 99%