Early second trimester herpes simplex virus type 2 (HSV-2) infection detection in an 18-week fetus: A case report

Herpes simplex virus type 2 (HSV-2) is closely linked to genital herpes infections. Also, maternal HSV-2 infections during pregnancy pose increased risks, particularly when expecting mothers are diagnosed in the third trimester, leading to unfavourable outcomes for the fetus that are rarely detected early in the second trimester. We present a case of HSV-2 infection in an 18-week fetus in a previously healthy mother. Fetal echocardiography during an anomaly scan at 18 weeks of pregnancy showed mild pericardial effusion, increased myocardial echogenicity, and thymic hypoplasia. Further investigations revealed evidence of HSV-2 infection in the amniotic fluid. Maternal serology for HSV at 20 weeks gestation was positive for HSV-2 IgG. The child was born with vaginal delivery at 38 weeks of pregnancy without any significant pathology or sequelae of HSV-2 infection. This case underscores the challenges associated with second-trimester intrauterine infections and prompts diagnosis based on ultrasound and echocardiography findings role in pregnancy outcomes.