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[quote=Anonymous][quote=Anonymous]If you look at the complications that can arise in newborns exposed to Herpes...it is sort of crazy that it isn't standard procedure to test for it.  [/quote]

It's not crazy if the information would not cause you to do anything differently. It only makes sense if there is something you could do differently, as a medical care provider, to help improve outcomes.

You can't clear herpes with treatment. It's not like knowing she tested positive would mean you could "fix it."

[u]If there are active lesions[/u], or if there is a primary infection (which means active lesions and a viral syndrome with sick symptoms) during the pregnancy, [u]then[/u] you manage the pregnancy differently -- depending on the timing, for example, you might recommend a C-section. But just having an HSV+ history without active lesions does not mean you improve outcomes by doing a C-section.

And you don't do antiviral suppressive therapy just for the hell of it, in case she is shedding virus but without active lesions. The risk-benefit analysis doesn't support it -- medications come with their own side effects.

https://www.guidelinecentral.com/summaries/management-of-herpes-in-pregnancy/#section-420
American College of Obstetricians and Gynecologists (ACOG). Management of herpes in pregnancy. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 2007 Jun. 10 p. (ACOG practice bulletin; no. 82). [68 references]

Excerpts:

[quote]
Recommendations:

Women with [b]active recurrent genital herpes [/b]should be offered suppressive viral therapy at or beyond 36 weeks of gestation.

Cesarean delivery is indicated in women with[b] active genital lesions or prodromal symptoms[/b], such as vulvar pain or burning at delivery, because these symptoms may indicate an impending outbreak.

Cesarean delivery is not recommended for women with a history of HSV infection but [b]no active genital disease[/b] during labor.[/quote]

And especially --

[quote]
[b]Routine antepartum genital HSV cultures in asymptomatic patients with recurrent disease are not recommended.[/b]

AND

[b][u]Routine HSV screening of pregnant women is not recommended.[/b][/u]

[/quote][/quote]

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