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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]
Wouldn't it be good information for a pregnant woman to be aware of?  So many weird changes happen to your body when you're pregnant.  If a woman knew that she tested positive for Herpes then she would know how important it was to report outbreaks to her doctor.

I've known people who have gone into labor at home and didn't make it to the hospital in time and wound up delivering at home or they were crowning by the time they got to the hospital with no time for a c-section.[/quote]

Not really. You might think so, until you look at the data. These are evidence-based guidelines derived from population-based data.

When you chase information for the sake of information (without looking at whether it positively affects outcomes), you end up introducing unnecessary procedures and having a lot of unintended negative consequences. I mean, women are free to request the testing. Clinicians are free to offer the testing. But when you do it in the absence of symptoms brought up by the patients, or symptoms elicited in questions by the clinician, or physical exam findings noted at the regularly scheduled visits, you tend to have worse outcomes overall. You introduce more problems than you fix.

Of course, if a given individual has a more high-risk history than average, or if there is something else that makes them atypical, clinical judgment comes even more into play. You can't standardize that.

But when it comes to typical cases, this stuff isn't always intuitive -- sometimes it's counterintuitive. That's why professional organizations have published guidelines and why they lay out the level of evidence and track the studies for those who want to dig deeper. [/quote]

That is the biggest double talk that I have had read.

Basically you are saying that arming women with information about their own bodies doesn't work because they are too stupid to do anything with information they get.  OMG.[/quote]

Nope. I'm saying you probably don't have medical training, an understanding of statistical analysis, or experience in working with population data. It's okay -- you just don't know what you don't know.

Look. You can ask your OB-Gyne or nurse midwife to be tested for anything you want to be tested for. Anyone can do that. And if they won't do it (they almost certainly would), you could easily find someone that would. And nobody here, including me, is saying that's a bad thing.

But ACOG is not going to recommend routine screening of all pregnant women given that many factors (of which the false positive rate is only one) add up to show -- in a demonstrable, measurable, and reproducible way when applied across a population -- in more errors and negative outcomes than they fix. [u]Especially[/u] when the only recommendations to changing practice are when there are other factors in the situation external to this testing.

And like I said -- if you want to get tested, get tested. Anyone can get tested. It's just not routinely recommended.

---

PS: This is not intuitive stuff, I know. But unintended negative consequences are real. For example, you'd think that routine screening for cystic fibrosis would be a good thing, right? Testing all newborns for this at the mandated heel prick would "arm families with information about their children's bodies" and medical futures, and that would be unequivocally good, right?

You'd be wrong. Children died sooner when identified as having this genetic disorder at birth.

They fixed the circumstances that fed into that, but without maintaining skepticism about the intuitively right answer, that would not have happened. And when it comes to general guidelines, there is more responsibility for being rigorous than when individuals are taking the responsibility by making the request for themselves.[/quote]

I think the one thing this thread/post is missing is the underlying fact that around 60% (or more) of people have HSV-1, and many never have symptoms.  For others, the major symptom is a cold sore on their mouth.  Absent active lesions, doctors can do blood tests.  That will tell you if you have HSV-1 or 2 antibodies.  It does not tell you if you have or will have any symptoms, or if you are shedding.  Asymptomatic viral shedding rates are different for HSV-1 or 2.

But here's the kicker, many people who have HSV-1 antibodies do not know that they have Herpes, and they would be freaked out if they learned it.  (They don't know that a cold sore is just as much herpes as genital infections.)  If doctors did C-sections just because of the existence of HSV-1 antibodies, the rate would go way up, which would have it's own complications.

The PP replying above seems to know a lot more about this than I do, but I suspect that the high percentage of people with HSV-1 is a major reason it is not usually tested for during pregnancy.  I've met several women who swore to me that they were tested for herpes, but when they really dug into their medical records, found out they weren't, just for other STDs.

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