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?

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.