Asymptomatic shedding of herpes simplex virus from the cervix and lesion site during pregnancy. Correlation of antepartum shedding with shedding at delivery
A. E. Wittek, A. S. Yeager, D. S. Au and P. A. Hensleigh
Asymptomatic shedding of herpes simplex virus (HSV) was detected in 0.83%
of 955 cultures obtained from pregnant women with culture-proved recurrent
genital HSV infections during pregnancy; seven (2.3%) of 299 women had
asymptomatic shedding. In addition, one (2.3%) of 42 pregnant women with
recurrent genital infection in the past but no attacks during pregnancy
shed HSV when asymptomatic. Shedding occurred more frequently from the
usual lesion site than from the cervix. The virus was not isolated at
delivery from women with asymptomatic antepartum shedding. When an active
lesion was present, concomitant shedding of HSV from the cervix occurred in
seven (3.6%) of 193 pregnant women with vulvar lesions and in one (2.1%) of
47 women with lesions remote from the vulva. Ninety-two percent of the
latter lesions were caused by type 2 HSV. In women who have had recurrent
genital HSV infections in the past, asymptomatic shedding occurs in those
with active attacks during pregnancy as well as in those asymptomatic
throughout pregnancy; however, asymptomatic shedding during the antepartum
period does not predict asymptomatic shedding at delivery.
