Genital herpes complicating pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Neonatal Health

Background:

• Herpes simplex virus (HSV) type 2 infects approximately 22% of pregnant women, with 2% acquiring HSV during pregnancy.
• A significant majority (up to 90%) of pregnant women with genital herpes remain undiagnosed due to asymptomatic or subtle presentations.
• Neonatal herpes, a severe complication, results from infant exposure to maternal genital secretions during birth.

Purpose of the Study:

• To highlight the critical importance of preventing neonatal herpes transmission.
• To emphasize the role of obstetricians in preventing vertical HSV transmission.
• To advocate for enhanced prevention strategies, including early risk identification and counseling.

Main Methods:

• Diagnosis relies on laboratory confirmation (culture, PCR) of genital lesions and serologic testing.
• Maternal HSV acquisition in the third trimester poses the highest risk for neonatal transmission.
• Obstetric management includes identifying active lesions for potential cesarean delivery and appropriate antiviral therapy.

Main Results:

• Despite diagnostic and treatment advances, neonatal herpes incidence and sequelae remain largely unchanged.
• Maternal acquisition of HSV during the third trimester significantly elevates the risk of neonatal herpes.
• Obstetric interventions like cesarean delivery and suppressive antiviral therapy can mitigate transmission risks.

Conclusions:

• Preventing initial neonatal herpes infection is paramount.
• Obstetricians play a vital role in preventing vertical HSV transmission through timely interventions.
• Enhanced prevention includes pre-conception or early pregnancy screening and counseling for at-risk individuals and partners.