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Management of Genital Herpes in Pregnancy

This guideline provides clinical guidance focusing on managing maternal infection to reduce the risk of transmission of herpes simplex virus (HSV) at birth.

This is a joint guideline with the British Association for Sexual Health and HIV (BASHH). It updates existing RCOG guidance on the management of genital herpes in pregnancy. It replaces Green-top Guideline No. 30 Management of Genital Herpes in Pregnancy, which has now been archived.

As the risk of herpes simplex virus (HSV) infection in pregnancy concerns the neonate rather than the mother, the focus of this guideline is on managing maternal infection to reduce the risk of vertical transmission at birth. Guidance is provided according to the type of maternal infection (primary or recurrent) and the gestational age at which infection occurred. The subsequent management of the neonate also reflects the mode of delivery and their condition. New to this guideline are sections on preterm prelabour rupture of membranes (PPROM) and the management of women who are HIV positive, and a clinical algorithm. In addition, a stronger recommendation to offer vaginal birth to women with a recurrent infection has been made.