Pregnant women with primary HSV infection have an increased risk of dissemination and hepatitis
(an otherwise rare complication in immunocompetent adults),particularly during the third trimester. To date, 27 cases of HSV hepatitis during pregnancy have been reported. 13 After patients with mmunosuppression, pregnant women are the largest group of adults with disseminated HSV infection; in one review, the mean gestational age at presentation was 31 weeks, and the case
fatality rate was 39% for both mothers and neonates.14 Other reviews have confirmed a high burden of HSV hepatitis among pregnant women; however, data on the incidence of primary HSV infection among pregnant women are limited. Recurrences of genital HSV infection increase in frequency during pregnancy, 17 although the clinical characteristics of recurrent genital HSV infection are similar in pregnant women and nonpregnant women