Ascending transcervical herpes simplex infection with intact fetal membranes

A case of herpes simplex infection in the placenta and in an immature infant delivered to a mother with proved genital herpes infection is discussed. Infection occurred without premature rupture of membranes. Viral transmission could be attributed to ascending transcervical infection based on evidence of necrotizing chorioamnionitis in absence of villitis plus extensive and severe involvement of the skin and lungs. Such distinct documentation of transcervical infection in the presence of intact fetal membranes makes it obvious that delivery by cesarean section cannot prevent all cases of neonatal herpes infection.