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Genital herpes in late pregnancy — DRCOG MCQ

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HardContraception and Sexual HealthGenital herpes in late pregnancyDRCOG

A 30-year-old woman at 37 weeks has a first episode of painful genital ulcers. She has no previous herpes history and is worried about the birth plan. Examination shows multiple tender vulval ulcers. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — HSV PCR swab from a lesion

Painful genital ulcers in late pregnancy should be swabbed for HSV PCR while urgent obstetric and sexual health advice is arranged. Cervical cytology does not diagnose genital herpes. CA125 and fetal anomaly scanning do not address the acute maternal infection question. The pearl is that first-episode herpes near term has important neonatal implications.

Reference: RCOG Green-top Guideline No. 30; BASHH genital herpes guideline