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HSV (Genital Herpes) in Pregnancy

Primary HSV infection close to delivery carries the risk of life-threatening neonatal herpes for the newborn.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is HSV (Genital Herpes) in Pregnancy?

Herpes simplex virus types 1 and 2 (HSV-1, HSV-2) are members of the herpes family that remain latent for life and reactivate periodically. Genital herpes is most often caused by HSV-2 and recently also HSV-1. Transmission occurs through sexual contact.

New primary infection in pregnancy, especially if acquired in the third trimester, significantly increases the risk of neonatal herpes (30-50%). Transmission risk is much lower in recurrent infection (1-3%). Neonatal herpes can range from skin-eye-mucosa form to central nervous system or disseminated disease and has high mortality.

Management involves preconception and early pregnancy history-taking, antiviral prophylaxis (acyclovir or valacyclovir) from 36 weeks, and cesarean section decision in the presence of active lesions. Diagnosis is made by PCR or viral culture.

Symptoms

Painful vesicles and ulcers in the genital area
Itching, burning, and inguinal lymphadenopathy
Dysuria
Flu-like illness (primary infection)
Vesicular rash in the newborn
Lethargy, convulsions, and sepsis presentation in the newborn
Asymptomatic viral shedding

Risk Factors

Primary infection in pregnancy
Lesion appearing close to delivery
Multiple partners
Unprotected sexual intercourse
HSV positivity in partner
Immunodeficiency

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • History inquiry in pregnancy planning or early pregnancy
  • When painful genital vesicles appear for the first time
  • Recurrent lesions before 36 weeks
  • Detection of active lesions when labor begins
  • When suspicious vesicles or sepsis presentation develops in the newborn

Treatment Methods

01
Acyclovir or valacyclovir in primary infection
02
Suppressive antiviral prophylaxis from 36 weeks
03
Cesarean section if active lesions or prodrome at delivery
04
IV acyclovir in the newborn (neonatal HSV treatment)
05
Differentiation of superficial, CNS, and disseminated forms in newborn
06
Partner counseling and safe sexual practice

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.