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

Abstract

The challenge for the prevention of acquisition of neonatal herpes is to identify those mothers at risk of acquiring herpes simplex virus (HSV) infection in pregnancy, and then to apply interventions to reduce this risk. Existing strategies to prevent neonatal herpes are based on recognition of clinical lesions in mothers at term, but these approaches may be of limited effectiveness, given that most cases of neonatal herpes result from unrecognized maternal acquisition of HSV in late pregnancy. The availability of type-specific serological tests for HSV-2 and HSV-1 now allows identification of at-risk pregnancies, and can enhance strategies to prevent both maternal and neonatal herpes infection. This may help to reduce the need for a Caesarean section, while promoting individual and public health gains.