One thorny issue is the management of genital herpes in pregnancy . There appears to be agreement that neonates are unusually susceptible to the systemic effects of genital herpes and that they can contract the disease at delivery. This is particularly so if the mother has a Primary infection. Women with a Primary infection should be delivered by Caesarean Section and the babies treated for herpes because of their exposure to maternal viremia. Things are less clear with Recurrent infections as the transmission rate to the neonate is much lower.
Vaginal delivery is acceptable if there are no visible lesions at the onset of labour.
All pregnant patients should be asked about previous herpes infections or exposure to herpes via a sexual partner.