Facts

Genital Herpes Simplex in pregnancy: presents with painful genital ulcers, fever, dysuria, pruritis.

Diagnosis by finding vesicular or ulcerated lesions, PCR, viral culture

Treatment of primary infection: treat with acyclovir, valacyclovir, famciclovir

Treatment of recurrent infection: treat with antivirals only if there are prolonged and severe symptoms.

Suppressive therapy at 36 weeks: For all women with a genital HSV anytime during pregnancy, initiate suppressive therapy at 36 weeks until the onset of labor, use 400 mg three times daily.

Delivery: mostly vaginal delivery; C-section if there are active genital lesions or pain and burning

Cesarean delivery can decrease but not eliminate the risk of neonatal HSV infection