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The genital herpes problem in pregnancy
B Guerra1, C Puccetti, F Cervi
1S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. brunella.guerra@unibo.it
Summary
Genital herpes (HSV) in pregnant women poses a risk of neonatal herpes. Preventing maternal HSV acquisition in late pregnancy and managing delivery exposure are key to infant protection.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Genital herpes is a common sexually transmitted infection with risks for reproductive-aged individuals.
- Vertical transmission to neonates is a significant concern, influenced by viral type and infection status (primary vs. recurrent) around delivery.
- Neonatal herpes, a severe complication, results from infant exposure to maternal genital herpes simplex virus (HSV) during labor.
Purpose of the Study:
- To review the risks and prevention strategies for neonatal herpes.
- To highlight the importance of preventing maternal HSV acquisition in late pregnancy.
- To discuss management options for pregnant women with genital herpes to minimize neonatal transmission.
Main Methods:
- Review of current literature on genital herpes in pregnancy and neonatal herpes transmission.
- Analysis of risk factors, including maternal HSV acquisition timing and infection type.
- Evaluation of preventive measures such as counseling, delivery mode, and antiviral therapy.
Main Results:
- Maternal HSV acquisition in the third trimester carries the highest risk of neonatal transmission.
- Prevention strategies include counseling against sexual contact in late pregnancy and avoiding infant exposure to lesions.
- Elective Cesarean section and antiviral suppressional therapy are discussed as management options.
- Routine maternal serologic screening is not currently recommended.
Conclusions:
- Preventing maternal genital HSV acquisition during late pregnancy is crucial for neonatal herpes prevention.
- Management strategies aim to minimize infant exposure to HSV during delivery.
- Further research should focus on recognizing asymptomatic primary genital HSV infections in mothers.
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