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Genital herpes first episode pregnancy — DFSRH MCQ

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HardSTI diagnosis and managementGenital herpes first episode pregnancyDFSRH

A 30-year-old at 34 weeks' gestation presents with painful vulval ulcers, dysuria and tender inguinal nodes. She has no previous history of herpes. HSV PCR is sent. What is the most appropriate management?

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

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Correct answer: A — Start aciclovir and seek specialist obstetric sexual health advice

First-episode genital herpes in late pregnancy requires prompt antiviral treatment and specialist advice because neonatal transmission risk influences delivery planning. Waiting for PCR may delay symptom relief and risk management. Doxycycline and cervical screening are not appropriate for this acute ulcer syndrome.

Reference: BASHH Genital Herpes Guideline; RCOG/BNF