Herpes simplex virus (HSV) infection is prevalent worldwide among women of childbearing age. During pregnancy, the major concern of maternal HSV infection is transmission to the fetus, as neonatal infection can result in serious morbidity and mortality. The major issues related to genital herpes infection in pregnancy will be reviewed here. The epidemiology, clinical manifestations, diagnosis, treatment, and prevention of primary and recurrent genital HSV infection in the general population, and issues related to management of the infected neonate, are discussed separately:
CLASSIFICATION AND SIGNIFICANCE OF HSV INFECTIONS
The clinical designations of genital herpes simplex virus (HSV) infection include: primary, first episode genital nonprimary, and recurrent infection (table 1). (See "Epidemiology, clinical manifestations, and diagnosis of genital herpes simplex virus infection".)
Both serologic and virologic assays are usually required for accurate designation , except in the case of well-documented recurrent genital herpes previously confirmed by culture or polymerase chain reaction (PCR) . Accurate classification of infection is particularly important during pregnancy, since newly acquired (primary or first episode genital nonprimary) infection near delivery is a major risk factor for transmission to the neonate. (See 'Predictors of neonatal infection' below.)
Primary genital infection — Primary genital infection refers to the first occurrence of HSV infection. These patients do not have preexisting antibodies to either HSV-1 or HSV-2. Type-specific antibodies to HSV generally develop within the first 12 weeks after infection and persist indefinitely .