Cesarean better option in HSV infection in 3rd trimester of pregnancy: ACOG

Because many women of childbearing age are infected or will be infected with HSV, the risk of maternal transmission of this virus to the fetus or newborn is a major health concern. This document has been revised to include that for women with a primary or nonprimary first-episode genital HSV infection during the third trimester of pregnancy, cesarean delivery may be offered due to the possibility of prolonged viral shedding.

According to new guidance from the American College of Obstetricians and Gynecologists, women who have a primary or non-primary first-episode infection of genital herpes simplex virus (HSV) in the third trimester of pregnancy may be offered cesarean delivery.

The change in guidance is because of the risk for prolonged viral shedding.

Herpes simplex virus–related deaths in infants are rare but increasing, and are now more common than those due to congenital syphilis or HIV.

Routine screening and treatment of pregnant women to prevent mother-to-child transmission is likely responsible for the declines in syphilis and HIV deaths. The experts feel that increase in HSV deaths may reflect an increase in perinatal HSV disease due to an increasing number of HSV-1–seronegative women, who are at risk for acquiring primary HSV when they are pregnant.

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