Herpes simplex virus (HSV) infections present most frequently as lesions on the lips or genital area. Specific protocols have been established regarding their management during pregnancy and the postpartum period in order to minimize the risk of transmission to the neonate. However, a significant number of women shed HSV asymptomatically from the cervix; This creates a challenge in obstetric management.
Recent evidence shows that antepartum cervical cultures are not predictive of intrapartum cervical shedding. Therefore, any other clues that might help in minimizing neonatal risk are vital. The presence of nongenital infection may indicate an increased occurrence of simultaneous cervical shedding. In fact, there have been cases of intrapartally-acquired neonatal infection with a maternal history of only nongenital infection.
This paper discusses nongenital herpetic infection, including the etiology, and its relationship to cervical shedding. Included is a discussion of previous cases of neonatal infection in mothers with a history of nongenital infection, and five case presentations of buttock infections.