Herpes simplex virus infection in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Neonatology

Background:

• Genital herpes simplex virus (HSV) types 1 and 2 infections during pregnancy present complex management issues.
• Both primary and recurrent genital herpes can manifest as severe ulcerations or asymptomatic viral shedding.
• Neonatal herpes, a serious complication, often arises from asymptomatic maternal shedding rather than symptomatic primary infections.

Purpose of the Study:

• To review the challenges in managing genital herpes during pregnancy.
• To discuss the transmission of herpes simplex virus to neonates.
• To evaluate current diagnostic and preventive strategies for neonatal herpes.

Main Methods:

• Review of literature on genital herpes simplex virus in pregnancy and neonatal herpes.
• Analysis of diagnostic methods including virus isolation, antigen detection, and serology.
• Evaluation of preventive strategies and management protocols.

Main Results:

• Most neonatal herpes cases are linked to asymptomatic maternal viral shedding.
• Current diagnostic tests struggle to rapidly identify at-risk mothers during labor.
• Antenatal screening for HSV is not yet proven effective.
• Clinical examination for genital lesions during labor remains a key strategy.

Conclusions:

• Preventing neonatal herpes is hindered by asymptomatic maternal shedding and diagnostic limitations.
• Close clinical monitoring of pregnant women for genital herpes lesions during labor is crucial.
• Cesarean delivery is recommended for mothers with active genital herpes lesions at delivery.
• Antiviral therapies are available for treating maternal and neonatal herpes infections.