Case 42 - A 20-Year-Old with a History of Herpes Presents for a New Obstetrical Visit

Summary

This is a case of a 20-year-old gravida 2 para 0 patient at 14 weeks’ gestation who presents for her initial prenatal care evaluation. The patient has a history of documented genital herpes infections and expresses concern about her condition and how it can affect her pregnancy. The case reviews the pertinent information needed to diagnose, counsel, and manage a pregnant patient with herpes simplex virus (HSV). Patients should be provided with routine prenatal care, including regular prenatal checkups, ultrasounds, and blood tests. Antiviral medications such as acyclovir and valacyclovir can reduce the severity and frequency of herpes outbreaks. The primary goal of diagnosis and treatment of HSV infections in pregnancy is to prevent neonatal herpes. Also, the use of acyclovir and valacyclovir started at 36 weeks as a prophylactic measure with patients with a recurrent history of HSV infection has been shown to reduce the rate of recurrent infections and active viral shedding at the moment of delivery, which are known risk factors for neonatal infection.