Managing genital herpes infections in pregnancy

Genital herpes is common and is becoming more so, with a seroprevalence of 25% in middle class primary care settings. Primary genital herpes in pregnancy most often is subclinical, but it also can cause severe illness. Further, active genital herpes at the time of vaginal delivery poses significant risk of neonatal infection, especially if the mother acquired the infection in the third trimester. It is important to prevent genital herpes acquisition in pregnancy and to diagnose recurrent genital herpes to prevent neonatal herpes.