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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2537
Experience:  30 years of experience and an award-winning educator.
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I am currently 39 weeks pregnant and at 33 weeks had a swab

Customer Question

Hello I am currently 39 weeks pregnant and at 33 weeks had a swab culture come back positive for HSV (unknown which type). My blood test came back negative and the midwife at the women's clinic wasn't sure what to make of that. I just saw an OB this week who told me that meant it was a primary infection and I should have been started on antiviral medication at 36 but I wasn't. They are just starting me on antiviral medication now at 39 weeks. I have been researching the likelihood of neonatal infection in the last trimester with a primary infection could be as high as 50 percent. My current ob recommended just taking my antiviral medication and as long as there is no sign of a breakout to do a vaginal delivery and basically hope for the best as we now know the risk involved. But I am wanting a second opinion as to if I should have a cesarean birth. Thank you.
Submitted: 3 months ago.
Category: OB GYN
Expert:  Dr David replied 3 months ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr David replied 3 months ago.

It has been recommended that a cesarean section should be performed if active vaginal herpes lesions are present at the onset of labor

However, if the membranes have been ruptured for more than 6 h, the benefit of a cesarean section has not been determined.

You are not at that point yet.

A cesarean section reduces, but does not eliminate, the risk of newborn infection

A recent prospective cohort study suggested that a cesarean section delivery reduces the risk of HSV among newborns by 86% in women who have active vaginal herpes lesions.

you don't have active lesions

so you can continue to take your antiviral medication

you can always have a C section to deliver your body

but if you don't have active lesions, then there is no proof that a C section will decrease risks of HSV spread to the baby more than a vaginal deliver.

let me know if you have questions.