The fetal prognosis in pemphigoid gestationis (herpes gestationis)

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Abstract
We have studied the infants in fifty pregancies affected by pemphigoid gestationis (herpes gestationis). There was a significant increase in the frequency of infants that were ‘small for dates'. As such infants have a raised mortality and morbidity it follows that in pemphigoid gestationis the fetal prognosis is impaired. In view of this it is essential that patients with pemphigoid gestationis are delivered in maternity units which have facilities for intensive care of the newborn. There has long been uncertainty over the fetal prognosis in pemphigoid gestationis (PG) (formerly called herpes gestationis) and this has not been dispelled by two recent studies. A literature review of immunofluorescence positive cases indicated that the risk to the fetus was substantial (Lawley, Stingl & Katz, 1978) while a further report found no evidence of increased morbidity or mortality (Shornick et al., 1983). The inconsitency of these studies may stem from the fact that their conclusion were based solely on the fetal outcome which could have varied with the standard of obstetric and perinatal care. A fundamental method of assessing fetal risk is to simply measure the infant weight and compare it with the weight expected for the gestation. This information has not been recorded in previous studies of PG. In our patients documentation of the infants’weights and gestations and calculation of the incidence of ‘small for dates’infants has enabled us to clearly define the fetal risk in PG.

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