[Genital herpes and childbirth]

Neonatal herpes is a serious infection due to the risk of diffusion and damage to the central nervous system. Depending on the author, the incidence of herpetic infection reported ranges from 1/7,500 to 1/1,000,000 neonates. type II herpes virus is responsible for three quarters of infections. The risk or in-utero damage is low, and does not exceed 5 percent of cases. Contamination usually occurs during delivery or during the immediate post-partum period. The clinical forms of neonatal infection consist essentially of diffuse forms, located in the central nervous system, and localized forms in the integuments and the eye. The prognosis for diffused forms and for damage to the central nervous system was particularly serious (two thirds mortality and a high risk of sequelae amongst survivors); but these results involve children who received anti-viral treatment too late. Primary maternal herpetic infection during the month preceding birth is the most serious risk for the neonate due to the high level of virus in the lesions and the absence of neutralizing antibodies. In this situation, the risk of neonate infection appears to be 75 percent. Fortunately, this situation is unusual. Recurrent infection is accompanied by a lower viral titer, viral elimination is rapid and the patient has neutralizing antibodies. The risk of neonatal involvement in the case of recurrence at the time of childbirth is thought to be less than 5 percent. In cases with a history of genital herpes in the mother or her partner, the risk of neonatal contamination is reported to be 1/1,000.(ABSTRACT TRUNCATED AT 250 WORDS)