Herpes simplex virus infection in pregnancy - An update

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Infectious Diseases

Background:

• Herpes Simplex virus (HSV) is a common sexually transmitted infection impacting women of reproductive age.
• Approximately 2-3% of pregnant women are affected by HSV, with a low risk of vertical transmission unless active lesions or viral shedding are present during delivery.
• Neonatal HSV infection can lead to severe outcomes, including disseminated disease, central nervous system involvement, skin/eye/mouth manifestations, and mortality.

Purpose of the Study:

• To provide a comprehensive overview of Herpes Simplex virus (HSV) in pregnancy.
• To discuss the diagnosis and management of HSV infections in pregnant women.
• To highlight unique clinical scenarios, such as prelabour preterm rupture of membranes and active disease during labor.

Main Methods:

• This is a review article.
• It synthesizes current knowledge on HSV in pregnancy.
• Focuses on diagnosis and management strategies.

Main Results:

• While vertical transmission is rare (<1%), the risk is elevated with active lesions or asymptomatic shedding during labor.
• Timely diagnosis and treatment of HSV in pregnant women can significantly reduce the risk of vertical transmission and neonatal sequelae.
• Routine screening for HSV in pregnancy is not recommended.

Conclusions:

• A high index of suspicion for HSV in pregnant women is essential.
• Appropriate management during acute and recurrent episodes is key to preventing adverse neonatal outcomes.
• Special attention is needed for cases involving prelabour preterm rupture of membranes and active disease at the time of labor.