Question:easy
Pregnant female with herpetic lesions in the vulva. Management is?
Pregnant female with herpetic lesions in the vulva. Management is?
Show Hint
Active genital HSV lesions at delivery are an absolute indication for Caesarean section to prevent neonatal transmission.
Updated On: Jun 23, 2026
- Acyclovir and elective Caesarean section
- Induction of labor
- Acyclovir and allow spontaneous progression of labor
- Wait and watch
Show Solution
The Correct Option is A
Solution and Explanation
Clinical scenario: Pregnant female + active herpetic vulval lesions = risk of neonatal HSV transmission during vaginal delivery.
Pathophysiology: Herpes Simplex Virus (HSV-2 predominantly) causes genital herpes. Neonatal infection occurs primarily during passage through the infected birth canal. Neonatal HSV has a mortality of 60% if untreated and leads to encephalitis and disseminated disease.
Management principles:
1. Acyclovir: Antiviral therapy suppresses active HSV replication, reduces lesion duration and viral shedding. Dose: 400 mg TDS or 200 mg 5 times/day for 5--10 days. Safe in pregnancy (FDA Category B).
2. Elective Caesarean section: Indicated when active genital HSV lesions or prodromal symptoms are present at the time of delivery (ACOG recommendation). Prevents direct contact of neonate with infected maternal genital tract.
Why not vaginal delivery? Even with Acyclovir, active lesions carry neonatal transmission risk of 30--50% with vaginal delivery.
Induction of labor through active lesions is contraindicated.
Wait-and-watch risks severe neonatal morbidity.
\[\boxed{\text{Acyclovir + Elective Caesarean section}}\]
Pathophysiology: Herpes Simplex Virus (HSV-2 predominantly) causes genital herpes. Neonatal infection occurs primarily during passage through the infected birth canal. Neonatal HSV has a mortality of 60% if untreated and leads to encephalitis and disseminated disease.
Management principles:
1. Acyclovir: Antiviral therapy suppresses active HSV replication, reduces lesion duration and viral shedding. Dose: 400 mg TDS or 200 mg 5 times/day for 5--10 days. Safe in pregnancy (FDA Category B).
2. Elective Caesarean section: Indicated when active genital HSV lesions or prodromal symptoms are present at the time of delivery (ACOG recommendation). Prevents direct contact of neonate with infected maternal genital tract.
Why not vaginal delivery? Even with Acyclovir, active lesions carry neonatal transmission risk of 30--50% with vaginal delivery.
Induction of labor through active lesions is contraindicated.
Wait-and-watch risks severe neonatal morbidity.
\[\boxed{\text{Acyclovir + Elective Caesarean section}}\]
Was this answer helpful?
0
Top Questions on Diagnosis of Pregnancy
Find the correct statements:
A. In human pregnancy, the major organ systems are formed at the end of 12 weeks.
B. In human pregnancy, the major organ systems are formed at the end of 8 weeks.
C. In human pregnancy, heart is formed after one month of gestation.
D. In human pregnancy, limbs and digits develop by the end of second month.
E. In human pregnancy, the appearance of hair is usually observed in the fifth month.
Choose the correct answer from the options given below:- NEET (UG) - 2025
- Biology
- Diagnosis of Pregnancy
- A woman presents with amenorrhea, linea nigra, nausea, vomiting, and bluish vagina. These are:
- NEET (PG) - 2025
- Gynaecology and Obstetrics
- Diagnosis of Pregnancy
- A pregnant female had Meconium stained liquor and underwent emergency LSCS. A few days later her condition deteriorated. USG showed edematous bowels. What's the cause ?
- NEET (PG) - 2020
- Gynaecology and Obstetrics
- Diagnosis of Pregnancy
- What is the use of the instrument given in the image below ?
- NEET (PG) - 2020
- Gynaecology and Obstetrics
- Diagnosis of Pregnancy
- Want to practice more? Try solving extra ecology questions todayView All Questions
