who should get tested for herpes? Every pregnant woman and her partner and as early into pregnancy as possible!! The further into pregnancy you go, the less reliable the testing is for the mother and you want to know your status and also your partner's status so you can protect your unborn baby! 1 out of every 2-3 people in the US alone has hsv1 and 1 out of every 4-5 has hsv2. It's not likely that both partners are completely hsv free so knowing who has what is important.
type specific herpes igg blood testing typically is not a part of routine std testing nor is it a part of routine pregnancy testing unfortunately. Be sure to talk to your obgyn about what testing is being done at your first prenatal appointment and make sure herpes is part of that testing. You don't want to have symptoms during the last few weeks of pregnancy and not have any idea if they could be herpes related or not and be worrying at a time you should be anticipating the arrival of your new baby! Make sure that your partner also seeks out testing too to know their status. You can transmit hsv1 to the genital area during oral sex as well as hsv2 can be transmitted during sex too. Since studies have confirmed over and over again that over 90% of people who have hsv2 have no idea they have it until they are tested, neither you nor your partner should assume anything about status. the two of you can't make educated decisions about what precautions to take until you know who has what. It's also important to your obgyn to know if this was a newly acquired herpes infection or not too during pregnancy so getting tested prior to pregnancy or early into it, helps determine that too. About 1/2 of all presumed newly acquired herpes infections actually aren't so having baseline test results is helpful to your provider.
so how should you get tested? type specific herpes igg blood testing is the best way to test. Make sure it's the right testing. ( http://westoverheights.com/herpes_handbook/index.html ) You don't want herpes igm blood testing done and you don't want non-type specific igg blood testing done either. A lesion culture when you have no symptoms genitally also isn't helpful. If you had symptoms that were cultured but came back negative, make sure that you follow up with type specific blood testing to confirm your status. Lesion cultures in general have a high false negative rate so appropriate follow up is important.
why is it important to get tested early into pregnancy? The longer you wait, the less likely it is your testing will be accurate due to the normal hemodilution of your blood from pregnancy. Blood testing during the last trimester especially is least accurate so you want it done long before that point.
so what if you have symptoms during pregnancy that you think are herpes related? Be seen asap!! You need a lesion culture and typing done of symptoms as early as possible - within 48 hours of symptoms appearing if at all possible. There is about a 5% risk of herpes being transmitted to your unborn child if you are infected during pregnancy so knowing for sure if you are newly infected during pregnancy is important so your obgyn can do the appropriate follow up for you ( additional ultrasounds to check on the baby ).
If you have questions, post them on the herpes forum - http://www.medhelp.org/forums/Herpes/show/195?camp=msc