What is the recommended delivery method for a patient with active genital lesions from HSV?

For a patient with active genital lesions from herpes simplex virus (HSV) at the time of delivery, a planned Caesarean section is the recommended method. This approach is guided by the need to prevent the transmission of the virus to the neonate during the passage through the birth canal, where exposure to infected lesions could occur.

The presence of active lesions indicates a higher likelihood of viral shedding, which significantly raises the risk of neonatal herpes, a serious condition that can lead to severe complications or even death in infants. By opting for a planned C-section, healthcare providers can effectively minimize this risk, as the surgical delivery circumvents any potential contact the newborn might have with the infected areas.

In contrast, vaginal delivery in the presence of active lesions would pose a risk of virus transmission. Induction of labor does not address the risk posed by the lesions and may lead to vaginal delivery anyway. Home birth lacks the necessary medical support and interventions that might be required in case of complications or emergencies associated with HSV transmission. Thus, a planned C-section remains the safest and most appropriate strategy for managing delivery in such cases.