Abstract
Since the pregnant woman's HSV infected genital tract is the source of virus in most cases of neonatal herpes, monitoring in the last trimester for genital virus in a woman with a history in herself or her partner is currently recommended as a method of possible prevention by C-section. We have examined the prevalence of a history of genital herpes, as well as measured HSV-2 antibodies (with an immunodot ELISA on nitrocellulose paper using a purified HSV-2 typespecific glycoprotein, gG-2) in two obstetric populations: a low socioeconomic (LS) group of 300 women and a middle class HMO group of 187 women. The prevalence of genital herpes in pregnant women by history in LS was 3.5% and in HMO 10%; including a history of genital herpes in the male partner, the rates were 1% and 13% respectively. The rates of HSV-2 antibodies in the pregnant women were 49% (LS) and 33% (HMO). Variability in history and antibody rates was noted according to age, race and awareness of the clinical entity of genital herpes. We conclude: (a) that a high proportion of obstetric patients are at some risk for transmitting HSV to their infants; (b) the current monitoring policy needs to be modified.The changing patterns of neonatal herpes as a consequence of the above, as well as other current findings to be discussed, will affect any new approaches to management of this severe neonatal problem.
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