Debate: the argument against. Should all pregnant women be offered type-specific serological screening for HSV infection?

The first goal in minimizing herpes simplex virus (HSV) mortality and morbidity in infants is to reduce the risk of acquisition of new infections during pregnancy, especially in late gestation. Antenatal testing does not necessarily predict the risk of transmission to the newborn infant, since this risk is variable. In order to identify newly acquired infection in women who are HSV-seronegative, repeat testing in late pregnancy would need to be offered. In those who are HSV-seropositive, concern for transmission to the infant is likely to result in administration of antiviral drugs to the mother or in Caesarean delivery. The potential consequence is medical intervention for many pregnancies that would not have been complicated by perinatal HSV transmission. Risk - and cost-benefit analyses are needed to assess HSV type-specific serological screening of pregnant women. Practical benefit can be achieved by counselling all pregnant women against oral or unprotected sexual contact during pregnancy.