Genital herpes is one of the most common sexually transmitted infections, affecting 1 in 6 people in the United States. Women are twice as likely to be infected as men and infections in women of reproductive age carry the additional risk of vertical transmission to the neonate at the time of delivery. Neonatal herpes infections can be devastating with up to 50% mortality for disseminated herpes simplex virus (HSV) infections in the newborn. Rates of transmission are affected by the viral type of HSV infection and whether the infection around delivery is primary or recurrent. Current management approaches decrease rates of active lesions at the time of delivery and thereby cesarean deliveries, but have not been shown to decrease the incidence of neonatal herpes infections. More research is needed to better elucidate the risk factors for transmission to the neonate and to improve our current management methodology to further decrease vertical transmission. In this review, we will discuss management of antenatal and peripartum herpes infections, considerations for mode of delivery, and the course of neonatal HSV infections.
Obstetricians & Gynecologists and Family Physicians
After the completing the CME activity, physicians should be better able to diagnose and manage genital herpes in the pregnant population, counsel patients appropriately regarding risk for vertical transmission based on viral subtype and type of infection and categorize the severity of neonatal herpes infections.
*Resident Physician, †Professor and Chair, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR; and ‡Physician, Department of Obstetrics, Gynecology, and Reproductive Sciences, Brigham and Women's Hospital, Boston, MA
Unless otherwise noted below, the authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.
Correspondence requests to: Gina L. Westhoff, MD, Resident Physician, PGY 4, Department of Ob/Gyn, OHSU, Mail Code L466, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239. E-mail: firstname.lastname@example.org.