Acyclovir treatment of primary herpes in pregnancy complicated by second trimester preterm premature rupture of membranes with term delivery: case report

Abstract

Primary genital herpes simplex virus (HSV) infection in pregnancy is associated with an increased risk of vertical transmission to the fetus, especially with rupture of membranes. Two cases of primary herpes and two cases of recurrent herpes in pregnancy with preterm premature rupture of membranes and expectant management have been reported, all delivering preterm. We report a case of primary maternal genital HSV infection with preterm premature rupture of membranes at 24 weeks' gestation who subsequently went on to deliver at term. This case was managed with intravenous acyclovir. Neonatal serology for HSV I (immunoglobulin M [IgM] and IgG) and HSV II (IgM) were negative. Antibodies for HSV II (IgG) were positive. Subsequent 6-month follow-up titers were negative for all herpes antibodies. On the basis of an extensive search of the English literature from 1966 to 2001, this is the first reported case of primary herpes in pregnancy associated with preterm premature rupture of membranes with a subsequent term delivery.