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A woman complains of discharge and soreness in the vulval region at a POA of 36 weeks. Examination reveals small discreet, tender ulcers in the labia majora, minora and perineum. She has not had a similar episode previously. On viral culture and serological testing she did not have antibodies against the infecting strain.What is the best treatment option?

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Correct Answer:
Treat with oral acyclovir and perform an elective cesarean section at 38 weeks
Description:
Ans. is d, i.e. Treat with oral acyclovir and perform an elective cesarean section at 38 weeksThis is a case of primary herpes because she does not have type-specific antibodies. The best management option is to deliver by cesarean section at 38 weeks, if primary herpes occurs in the third trimester, especially during the last 6 weeks, as there is no time for the mother to develop antibodies. It is not necessary to perform a cesarean section immediately as transplacental transmission does not occur. Treatment with acyclovir is indicated in primary herpes as it reduces the severity and the duration of the maternal disease.
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