Silent Herpes Simplex virus infection in women with preterm premature rupture of membranes


Background: genital herpes simplex virus infection in pregnancy poses a major risk to the fetus and it has been associated with bad obstetric out come causing preterm labor, intrauterine growth retardation and spontaneous abortion. This study was conducted to determine if premature rupture of membranes before 37 weeks of gestational age are observed with subclinical shedding of herpes simplex virus (HSV).Patients and methods: Cervical swabs were taken from 75 women with a history of preterm premature rupture of membranes before 37 weeks of gestation, and 20 women with normal obstetrical history for the presence of HSV antigen using Enzyme linked Immuno Sorbent Assay (ELISA) method.
Results: HSV antigen was detected in 37 swabs(49.3%) which revealed a significant association with preterm premature rupture membranes(PPROM) compared to control group(P<0.05).The majority of HSV infected women were asymptomatic 34(91.9%), and 23(56.1%) of the cases was associated with history of recurrent PPROM, compared to those women with history of single PPROM.Conclusion: The risk of maternal transmission of HSV to the fetus or newborn is a major health concern and the high rates of undiagnosed or asymptomatic HSV infections complicate the issue of prevention. With advent of serologic test that can reliably detect the virus in asymptomatic patient. Maternal HSV screening now is mandatory.