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HSV in Pregnancy
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Suppression at 36 weeks; C-section if active lesions in labor.
Decision
Outcome
Decision
Pregnant patient with prior HSV — management?
✓
Antiviral suppression (acyclovir/valacyclovir) starting at 36 weeks
✓
No prior HSV → routine prenatal care
Decision
Lesion or prodrome at labor?
✓
Yes → cesarean delivery
✓
No → vaginal delivery
Outcome
Cesarean to prevent neonatal HSV
Outcome
Vaginal delivery is safe
Outcome
Routine care; counsel partners to avoid transmission, especially in 3rd trimester