Incidence of genital herpes simplex virus at the time of delivery in women with known risk factors.

A total of 143 women with known risk factors for genital herpes simplex virus had cultures performed at the time of delivery. A total of 123 were without symptoms, of which three (2.4%) had positive herpes simplex virus cultures at the time of delivery. Fifteen women had lesions clinically consistent with genital herpes simplex virus at the time of delivery and five (33.3%) were culture positive. Five women had only prodromal symptoms of genital herpes simplex virus, but two of these (40%) had positive herpes simplex virus cultures from the site of previous lesions. Of the 10 women with positive herpes simplex virus cultures in this group of 143, no infant was delivered with evidence of neonatal herpes simplex virus infection, including two who had vaginal deliveries. The results of this study support the recommendations that in women without symptoms but with known risk factors for genital herpes simplex virus, a trial of vaginal delivery be allowed and that in women with either a lesion clinically consistent with genital herpes simplex virus or prodromal symptoms of genital herpes simplex virus a cesarean section be the mode of delivery.