"Testing Pregnant Women
Consider testing pregnant women who are at risk of acquiring herpes in the third trimester. These are women without a history of genital herpes whose partner is known to be infected or is seropositive. Infection of the neonate is most common when the mother develops primary infection late in pregnancy. Transmission of herpes to the neonate during birth results in neonatal herpes, with devastating results.
A pregnant seronegative woman could be identified and counseled to avoid transmission during the third trimester. An HSV-2_eropositive woman can be informed that her risk of transmission to her fetus is low and that most patients can have a vaginal delivery. If a woman is entirely seronegative and her partner is HSV-1 positive, they should be instructed to avoid oral-genital and genital-genital contact in the last trimester, as HSV-1 accounts for up to 30% of cases of neonatal herpes. Consider suppressive therapy for seropositive men unwilling to abstain or to use condoms. "
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