Herpes simplex virus and pregnancy: a review of the management of antenatal and peripartum herpes infections

Obstet Gynecol Surv. 2011 Oct;66(10):629-38. doi: 10.1097/OGX.0b013e31823983ec.


Genital herpes is one of the most common sexually transmitted infections, affecting 1 in 6 people in the United States. Women are twice as likely to be infected as men and infections in women of reproductive age carry the additional risk of vertical transmission to the neonate at the time of delivery. Neonatal herpes infections can be devastating with up to 50% mortality for disseminated herpes simplex virus (HSV) infections in the newborn. Rates of transmission are affected by the viral type of HSV infection and whether the infection around delivery is primary or recurrent. Current management approaches decrease rates of active lesions at the time of delivery and thereby cesarean deliveries, but have not been shown to decrease the incidence of neonatal herpes infections. More research is needed to better elucidate the risk factors for transmission to the neonate and to improve our current management methodology to further decrease vertical transmission. In this review, we will discuss management of antenatal and peripartum herpes infections, considerations for mode of delivery, and the course of neonatal HSV infections.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Cesarean Section
  • Female
  • Herpes Genitalis / diagnosis*
  • Herpes Genitalis / mortality
  • Herpes Genitalis / therapy*
  • Herpes Genitalis / transmission*
  • Herpes Simplex / diagnosis*
  • Herpes Simplex / mortality
  • Herpes Simplex / therapy*
  • Herpes Simplex / transmission*
  • Humans
  • Infectious Disease Transmission, Vertical
  • Mass Screening
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / mortality
  • Pregnancy Complications, Infectious / therapy*
  • Prenatal Diagnosis / methods
  • Risk Factors
  • Severity of Illness Index
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / mortality
  • Sexually Transmitted Diseases / therapy*
  • Sexually Transmitted Diseases / transmission*


  • Antiviral Agents

Supplementary concepts

  • Neonatal herpes