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Herpes Simplex Virus Infections in Pregnancy

Transmission of HSV occurs by virus direct contact. 5-10% of population has a history of symptomatic HSV-2 genital herpes.

Clinical Presentation

Primary Genital Herpes is caused by initial infection with either HSV 1 or 2, without prior exposure. Systemic symptoms include headache, fever, malaise, and numerous bilaterally distributed genital lesions.

Non-primary First Episode is the first clinical episode of HSV-1 or 2 in a patient with prior exposure to the other vial serotype. The episode is usually less severe.

Recurrent Herpes is caused by reactivation of latent virus. The mean time interval to a subsequent recurrence is 40-60 days. Most patients have 4-6 recurrence per year.

Laboratory Diagnosis

Viral culture requires one week.

Monoclonal antibody on cytologic smears provides results in 3 hours. It is 92% sensitive and 94% specific.

Polymerase chain reaction (PCR) is more sensitive.

Pregnancy does not influence the recurrence risk of 0.1-4.0%.

Neonatal Syndromes

Forms of infection include infection of skin, eye, or mouth only; CNS infection; and disseminated disease.

Neonatal infection may develop after delivery from mothers with either active or asymptomatic disease.