Infection with herpes simplex is one of the most common sexually transmitted infections. Because the infection is common in women of reproductive age it can be contracted and transmitted to the fetus during pregnancy and the newborn. Herpes simplex virus is an important cause of neonatal infection, which can lead to death or long-term disabilities. Rarely in the uterus, it occurs frequently during the transmission delivery. The greatest risk of transmission to the fetus and the newborn occurs in case of an initial maternal infection contracted in the second half of pregnancy. The risk of transmission of maternal-fetal-neonatal herpes simplex can be decreased by performing a treatment with antiviral drugs or resorting to a caesarean section in some specific cases. The purpose of this paper is to provide recommendations on management of herpes simplex infections in pregnancy and strategies to prevent transmission from mother to fetus. 1. Introduction Herpes simplex virus (HSV) is an ubiquitous, enveloped, and doublestranded DNA virus, belonging to the family of Herpesviridae transmitted across mucosal membranes and nonintact skin, that migrate to nerve tissues, where they persist in a latent state. HSV-1 predominates in orofacial lesions, and it is typically found in the trigeminal ganglia, whereas HSV-2 is most commonly found in the lumbosacral ganglia [1]. Nevertheless these viruses can infect both orofacial areas and the genital tract. In some developed countries type 1 has recently emerged as the prominent causative agent in genital lesions. Changes in sexual behaviours of young adults may partly explain its higher incidence [2, 3]. A first primary infection develops when a susceptible person (lacking of preexisting HSV-1 and HSV-2 antibodies) is exposed to HSV. Indeed, a first nonprimary episode occurs when a person with preexisting HSV antibodies (against type 1 or 2) experiences a first episode with the opposite HSV type. Recurrent infection occurs in a person with preexisting antibodies against the same HSV type [1]. Infections during pregnancy may be transmitted to newborns: HSV-1 and HSV-2 may cause eye or skin lesions, meningoencephalitis, disseminated infections, or foetal malformations. 2. Epidemiology In recent years, genital herpes has become an increasing common sexually transmitted infection. From the late 1970s, HSV-2 seroprevalence has increased by 30%, resulting that one out of five adults is infected [4, 5]. HSV seroprevalence in patients with STD varies from 17% to 40% (6% in the general population and 14% in pregnant women) [6, 7].
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