HSV in pregnancy
From IDWiki
Background
- Infection with herpes simplex virus during pregnancy
Epidemiology
- Risk of perinatal transmission varies by maternal serostatus relative to the active infection at the time of delivery
- Newly acquired
- First-episode primary infection (mother has no serum antibodies to HSV-1 or -2 at onset): risk of transmission is about 60%
- First-episode nonprimary infection (mother has a new infection with one HSV type in the presence of antibodies to the other type): risk of transmission is less than 30%
- Recurrent (mother has pre-existing antibodies to the HSV type that is isolated from the genital tract): risk of transmission is less than 2%
- Newly acquired
| Serology | Infected with | Risk of perinatal transmission | Neonatal HSV per 100,000 births |
|---|---|---|---|
| Negative | HSV-1 or -2 | 60% | 54 |
| HSV-1 only | HSV-2 | ≤30% | 26 |
| HSV-2 only | HSV-1 | 35 | |
| HSV-1 + HSV-2 | HSV-1 or -2 | ≤2% | 12 |
| HSV-2 ± HSV-1 | 22 |
Clinical Manifestations
- If acquired during pregnancy, HSV can cause spontaneous abortion and should be treated for 7 to 10 days
- Can also cause congenital HSV in the fetus
Management
- If HSV-2-positive, then if there are lesions or PCR-positivity at time of labour, could consider Cesarean section
