Question

Pregnant female with herpetic lesions in the vulva. Management is?

• A. Acyclovir & elective Cs
• B. Induction of labor
• C. Acyclovir & allow spontaneous progression of labor
• D. Wait & watch

Answer 1

The Correct Option is A

When managing a pregnant female with active herpetic lesions on the vulva, the priority is to minimize the risk of neonatal herpes transmission, which can be severe. Here's the structured approach to managing this scenario:

1. Understand the Risk:
Herpes simplex virus (HSV), particularly when primary infection occurs or active lesions are present at the time of delivery, poses a significant risk of transmission to the neonate. This can lead to neonatal herpes, a serious condition with potential for high morbidity and mortality.

2. Management Strategy:
The objective is to prevent HSV transmission. The recommended management involves two critical steps:

(a) Antiviral Therapy: Administer Acyclovir to manage and suppress the viral replication. This reduces viral shedding and can help heal the lesions more quickly.
(b) Mode of Delivery: Opt for an elective Cesarean section (Cs). This is particularly recommended when active lesions are present at the onset of labor, as it significantly reduces the risk of neonatal exposure to the virus during the birthing process.

Conclusion: The correct management option, given the presence of herpetic lesions, is to administer Acyclovir and plan for an elective Cesarean section. This approach aims to effectively manage the mother's condition while safeguarding the newborn from potential HSV transmission.