herpes in pregnancy
- related: Infections in Pregnancy
- The most common mode of vertical transmission is direct contact between the fetus and genital tract lesions (eg, cervix, vagina, vulva) during vaginal delivery.
- low risk of vertical transmission in patients without an active HSV lesion or prodromal symptoms (eg, malaise, myalgia).
- the most effective strategy to decrease the risk of vertical transmission is to prevent an active HSV lesion at the time of delivery with suppression
- Therefore, patients with a history of HSV are provided acyclovir suppression beginning at 36 weeks gestation that is continued until delivery.
- At delivery, patients without prodromal symptoms or active genital HSV lesions can be delivered vaginally as the risk for perinatal transmission is minimal.
- Patients with active genital HSV at delivery require a cesarean delivery to prevent direct contact between the fetus and the lesion
Links to this note