A 37-week pregnant patient diagnosed with genital herpes asks about the potential impacts on delivery. What should the nurse educate the patient regarding the management of herpes during delivery?

Choice A rationale If a pregnant patient has active genital herpes lesions or prodromal symptoms (like vulvar pain or burning) at the onset of labor, the risk of transmitting the Herpes Simplex Virus (HSV) to the neonate during vaginal delivery is high. Neonatal HSV infection is severe and potentially fatal, making an elective cesarean delivery the recommended procedure to prevent vertical transmission. Choice B rationale Planning a home delivery is strongly contraindicated for a high-risk condition like active genital herpes near term. Delivery must occur in a hospital setting with access to full surgical and neonatal intensive care resources, due to the high risk of neonatal infection and the potential for rapid deterioration if maternal complications arise. Choice C rationale Antiviral medications, such as acyclovir, are often continued or started near term (around 36 weeks) to suppress viral shedding and reduce the likelihood of an active outbreak at delivery. Discontinuing them two weeks before delivery would increase the risk of recurrence and necessitate a cesarean section, thus this action is inappropriate. Choice D rationale While the risk is highest with visible lesions, asymptomatic viral shedding can still occur, meaning HSV can be transmitted even in the absence of visible lesions. However, the risk is significantly lower. Suppressive therapy is aimed at minimizing this risk, but a completely normal vaginal delivery may still carry a small risk. .