<prompt> A 25-year-old G1P0 female at 25 wks of gestation comes to you for antenatal check up. She has had an uncomplicated pregnancy but has 5 years history of Genital Herpes infection. She is usually asymptomatic and has had 3 flares in the past 5 years. She is concerned about exposing her unborn child to infection-What is the most appropriate counsel to offer to this patient.Administer one dose of acyclovir if she has active genital herpes at the time of delivery.Administer prophylaxis with acyclovir from now and uptil delivery whether she has active herpes or not.Perform elective LSCS even if mother is asymptomatic at the time of delivery.Perform elective LSCS only if mother has active herpes at the time of delivery.  <response>: Herpes Simplex Virus infection in pregnancy:Most common time of Mother To Child transmission isat the time of deliveryAbout 50 women with HSV is first trimister abort while infection in second half can lead to IUGR, preterm labor.ACOG does not recommend a routine screening for HSVViral isolation is the defective means of diagnosis for HSV infectionSpecimens are obtained from any active lesions as well as from cervix and vaginaPCR can also be doneDOC during pregnancy-Acyclovir safe in lactation also × 710 daysACOG recommends daily viral therapy at or beyond 36 weeks for women who have recurrences during pregnancy as it decreases the outbreaks at term and so decreased need for cesarean Cesarean section is indicated for women with active genital lesions or in patients having prodromal symptoms of herpes viz genital pain and tingling ans 22. Cesarean is not indicated in women with a ho HSV infection but no active genital tract lesionprodromal symptoms at the time of delivery.If no active breast lesions are presentpatient can breastfeed.Now with this background about HSV infection, lets have a look at the optionsOption a: administer one dose of acyclovir if she has active genital herpes at the time of delivery-incorrect as acyclovir should be given for 710 days in case of active herpes infection.Option b: administer prophylaxis with acyclovir from now and uptil delivery whether she has active herpes or notagain incorrect as we have to give acyclovir for 710 days, then stop and restart at 36 weeks of gestation.Option c: perform elective LSCS even if mother is asymptomatic at the time of delivery. again IncorrectOption d: perform elective LSCS only if mother has active herpes at the time of delivery. correct 