Management of genital herpes simplex virus infection during pregnancy.

The clinical course and outcome of 58 pregnancies in 57 women with culture-verified genital herpes simplex virus (HSV) infection during gestation are reported. In 19 cases (33%) an active genital HSV infection was present within 1 week of delivery. Of the 60 infants delivered, 58 survived. No maternal or perinatal morbidity or mortality was attributable to HSV. This experience suggests that weekly culturing of the cervix and all other previously infected genital sites from the 36th week of gestation until delivery is an acceptable plan for managing such pregnancies. Women without evidence of infection at the onset of labor can be allowed to deliver vaginally. With appropriate precautions, breast-feeding by mothers with genital HSV infections is not contraindicated.