A pregnant woman with genital herpes desires a natural vaginal delivery. What method of delivery is indicated given the presence of lesions?

In the case of a pregnant woman with genital herpes who has active lesions at the time of delivery, a cesarean delivery is indicated to minimize the risk of neonatal herpes transmission. When there are visible genital lesions, the herpes virus can be passed to the baby during a vaginal delivery, potentially leading to serious complications, including neonatal herpes, which can be life-threatening.

The primary concern is the safety of the newborn. If lesions are present, the risk of the virus being transmitted to the infant during the passage through the birth canal is significantly heightened. Therefore, even if the mother desires a natural vaginal delivery, the presence of lesions necessitates a cesarean delivery to protect the health of the infant.

Other options may suggest that vaginal delivery could still be considered; however, the medical consensus prioritizes the avoidance of risk to the newborn when active herpes lesions are present. The recommendation aligns with guidelines aimed at preventing vertical transmission of the virus during delivery.