Herpes Simplex Virus Perinatal Management

Abstract

Aim
Herpes Simplex Virus (HSV) is a double stranded deoxyribonucleic acid (DNA) virus with 2 serotypes, HSV-1 and HSV-2. Neonatal HSV infection is uncommon due to evidence-based interventions for pregnancy, delivery and the newborn. The study assessed whether pregnant women with a history of genital HSV and their infants were managed according to best practice recommendations.

Methods
A retrospective analysis of pregnancies between January 2018 and December 2021. Included were women with documented HSV – either diagnosed, treated, or with positive laboratory testing.

Results
234 women with 261 pregnancies were identified. Mean maternal age was 32 (SD =/- 5.2). 110 (42%) pregnancies had visible lesions. 2 (0.07%) cases of primary HSV occurred within 6 weeks of delivery. 11 (4.2%) had lesions at labour onset – all were recurrences. Prophylaxis was prescribed in 178 (68%) pregnancies. 14 (5%) infants required evaluation, with only one yielding a positive swab requiring full acyclovir treatment.

Discussion
Genital HSV prevalence in this population was 0.07% (2 cases), with incidence of 0.003% (1 case) of infant requiring treatment throughout this timeframe. Primary infection within 6 weeks of delivery was rare, with no cases at labour onset. Recurrent lesions were reported in under 50% (110 pregnancies). Requirement for infant evaluation was low (5%, 14 infants).