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M-V Sénat1, O Anselem2, O Picone3

  • 1Service de gynécologie-obstétrique, hôpital Bicêtre, AP-HP, 78, avenue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Université Paris-Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France.

Gynecologie, Obstetrique, Fertilite & Senologie
|November 15, 2017
PubMed
Summary

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This summary is machine-generated.

Managing genital herpes in pregnancy requires careful diagnosis and treatment to prevent neonatal herpes. Antiviral prophylaxis and timely delivery decisions are key, though evidence for reducing neonatal herpes risk is limited.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Neonatology

Background:

  • Genital herpes, primarily caused by HSV2, poses risks during pregnancy.
  • HSV seroconversion during pregnancy occurs in 1-5% of cases.
  • Neonatal herpes, mainly HSV1, can occur even without maternal history.

Purpose of the Study:

  • To identify diagnostic, preventive, and treatment measures for genital herpes in pregnant women.
  • To outline strategies for managing neonatal herpes infection.
  • To assess the effectiveness of interventions in reducing neonatal herpes transmission.

Main Methods:

  • Comprehensive bibliographic search of Medline and Cochrane Library databases.
  • Review of international clinical practice guidelines.
Keywords:
First episode of genital herpesMode d’accouchementMode of deliveryPrimo-infection herpétiqueProphylactic treatmentRecurrenceRécurrenceTraitement curatifTraitement préventif

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  • Analysis of evidence regarding diagnostic confirmation, antiviral therapy, and delivery management.

    • Main Results:

    • First-episode genital herpes in pregnancy warrants virological confirmation and antiviral treatment (acyclovir or valacyclovir).
    • Recurrent herpes may be treated with antivirals; prophylaxis from 36 weeks is recommended for first episodes or recurrences.
    • Cesarean delivery is advised for suspected first episodes near term or with premature membrane rupture; vaginal delivery considered for recurrent herpes with prolonged rupture.

    Conclusions:

    • While direct evidence for reducing neonatal herpes risk is lacking, appropriate management can alleviate maternal symptoms and reduce recurrence.
    • Antiviral prophylaxis and careful delivery planning are crucial for managing herpes in pregnancy.
    • Neonatal herpes requires prompt diagnosis and intravenous acyclovir treatment.