Disseminated herpes simplex in pregnancy: two cases and a review.

Documented disseminated infection with herpes simplex virus has been reported only five times in pregnancy. All cases have been severe and demonstrated common clinical features, including hepatitis and adenopathy. These reports are reviewed and two new cases added. Dissemination is undoubtedly more common, and commonly less dramatic in presentation then previously suspected. Hepatocellular dysfunction and generalized adenopathy should be clues to dissemination. Dissemination has occurred only in the second half of pregnancy, and even with infected amniotic fluid, has not always resulted in an infected infant. Transplacental maternal IGG has been documented, but is not protective, though newer antiviral drugs do show therapeutic potential. The clinician should be aware of the possibility of dissemination in any patient with oral or genital herpes and generalized signs or symptoms of disease.