Pemphigoid Gestationis (Herpes Gestationis)

Study Objective

To retrospectively evaluate the complications of the laparoscopic pelvic surgeries and to formulate the guidelines to avoid them.

Design

Retrospective study (Canadian Classification).

Setting

Advanced Laparoscopic Institute.

Patients

Nine hundred and seven operated for gynecological malignancies.

Intervention

Laparoscopic surgeries.

Measurements and Main Results

567 women suffering from different pelvic conditions were studied in a period of 60 months. The median age of the patient was 35 (11–80). Complications occurred in 32 patients (32/567, 5.5 %). The overall incidence of urinary tract injury in all the advanced cases at our institute was 2.1 % (12/567). The incidence of bowel injury at our center was 1.76 %. The incidence of vascular injury at our institute was 1.76 % (10/567).

Conclusion

Laparoscopic complications are different than those seen following open surgeries. Anticipation, early recognition, and timely intervention help to reduce morbidity. Laparoscopic management of complications is possible. Formulating standard guidelines can help to avoid many such complications.     

Herpes gestationis

A case of clinically typical herpes gestationis is presented. The diagnosis was confirmed by light microscopy and immunofluorescence studies. The symptoms subsided at delivery, but recurred during subsequent oral contraceptive medication. The newborn infant was affected temporarily. The treatment, the fetal risk and the implications of the diagnosis on future pregnancies and contraceptive therapy are discussed.     

Herpes simplex virus

Genital herpes simplex infection remains an infectious disease having widespread consequences for both adult and neonatal populations. Physicians must understand that the psychologic impact of genital HSV infections frequently is more disabling than the physical manifestations. Sensitivity, compassion, and support are necessary from members of the medical community, and psychologic counseling may help patients cope with HSV and all its implications. Similarly, physicians must downplay the hysteria that has been associated with herpesvirus infections, emerging as a result of intense media coverage in the 1970s and 1980s. Minimizing the number of cases of neonatal herpes through identification of infected women during parturition continues to be important. Recent guidelines suggest a rationale for the management of women at risk for genital HSV. Nevertheless, until newer immunologic and serologic techniques become clinically reliable and allow a correct and rapid diagnosis of herpes simplex infection, identification of the infected woman in labor must be made using detailed clinical history, physical examination, and viral culture.     

Herpes in pregnancy

The management of genital herpesvirus infections in pregnancy has seen many changes over the past decade as we have continued to learn more about the epidemiology of the disease. This article reviews these changes and highlights ongoing controversies. Clinical management schemes are proposed based upon this most recent information.     

Genital Herpes An Overview

Data from the National Disease and Therapeutic Index (NDTI) Survey indicate that the number of physician-patient consultations concerning genital herpes increased 15-fold between 1966 and 1984. Because of the increased incidence of genital herpes, the great variance in symptoms and severity of outbreaks, and the frequent misrepresentation of the nature of herpes simplex, all health-care practitioners should receive up-to-date information on the disorder. This article is intended to educate health-care professionals about genital herpes.