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Joint RCOG/BASHH release: Managing genital herpes in pregnancy – new information published

News 17 October 2014

Looking after women with genital herpes in pregnancy is explored in new guidelines and patient information published jointly today by the Royal College of Obstetricians and Gynaecologists (RCOG) and the British Association for Sexual Health and HIV (BASHH).

The consensus guideline replaces previous separate guidelines and covers the inpatient and outpatient management of genital herpes in the antenatal, intrapartum and postnatal periods. The new patient information is based on the guideline and provides information for women and their families.

Genital herpes is a common infection caused by the herpes simplex virus (HSV). There are two types of HSV, type 1 and type 2. Both types can cause infection in the genital and anal area. Approximately 50% of neonatal herpes is due to type 1 and 50% due to type 2.

Neonatal herpes is when a baby catches the herpes virus at birth. It can be serious, but is very rare in the UK (1 to 2 out of every 100,000 newborn babies). The baby will be cared for in a neonatal unit with a specialist team of doctors.

The risk of transmission is greatest, however, when a woman acquires a new infection (primary genital herpes) in the third trimester and particularly within 6 weeks of delivery, as the baby is unlikely to have protective antibodies.

The guidelines cover management of women with herpes in the first or second trimester and mode of delivery for women who have a first episode in the third trimester. For women with recurrent genital herpes where the risk of neonatal herpes is very low, the guidelines state that vaginal delivery should be anticipated if there is no other reason to have a caesarean section.

The new information also provides advice on treatment for genital herpes such as antiviral tablets which are safe to take in pregnancy and whilst breastfeeding.

To help prevent postnatal transmission of HSV, advice should be given around practising careful hand hygiene.

Dr Manish Gupta, co-Chair of the RCOG Guidelines Committee said:

“We are delighted to have joined forces with BASHH to provide one consensus guideline on genital herpes in pregnancy.

“This guideline is aimed at healthcare professionals working in maternity units and in community care. It is important that a multidisciplinary team approach is taken involving midwives, obstetricians, genitourinary medicine physicians and neonatologists to ensure the woman and her baby receive the best possible care.”

Dr Elizabeth Foley, lead author of the guideline, consultant in Genitourinary and HIV Medicine, and BASHH representative added:

“This new guideline provides essential information for healthcare professionals. Genital herpes is a common infection. However, transmission to the baby is rare.

“BASHH is pleased to be partnering with the RCOG on the development of the guideline and patient information and hope it will be a valuable resource. There is new information on genital herpes in preterm rupture of membranes and managing HIV positive women with the virus.”

Chair of the RCOG’s Patient Information Committee, Philippa Marsden, said:

“This patient information is for women if they are pregnant and want to know about genital herpes and pregnancy. Partners, relatives or friends may also find it helpful.

“Women will be reassured to know that genital herpes can be treated safely during pregnancy. In addition unless it happens for the first time later on in pregnancy, most women can have a vaginal birth.”

Ends

For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email pressoffice@rcog.org.uk