Genital Herpes in Pregnancy

most women who suffer from genital herpes give birth to healthy children. Nevertheless, there is a very low risk of infection for the baby and if that happens, it can have serious or fatal consequences. Therefore, it is important that you inform your midwife and your doctor if you or your partner ever had a genital herpes outbreak, or if you suspect only the appropriate symptoms. Only then can all security measures be taken.

What is Genital Herpes?

Genital Herpes is triggered by the herpes simplex virus, a causative agent that also causes cold sores. Genital herpes is usually caused by the herpes simplex virus type 2 (HSV-2), while the blisters on the mouth are caused by the herpes simplex virus type 1 (HSV-1). Nevertheless, genital herpes can be caused by HSV-1. Once you get infected with the herpes virus, it will stay in your body for a lifetime and will be active from time to time.

How does genital herpes affect my pregnancy?

If you have ever had genital herpes before pregnancy, the risk of your baby infecting you is very low, even if you have an outbreak during pregnancy or even during labor. That's because your body has already produced antibodies against the herpes simplex virus.

Your baby will be immune for up to three months after birth. However, caution is needed, because there is no guarantee for the immune protection. Therefore, avoid direct contact between the infant and people with acute herpes infections in the first weeks of life of your baby, whether genital or on the lips.

If you have genital herpes for the first or second trimester of pregnancy, there is little risk of it affecting your baby. The infection was associated with miscarriage, intrauterine growth retardation IUGR (the baby is not growing properly), premature labor (Low-Beer and Smith 1996), microcephaly (when the child's brain is underdeveloped), encephalitis (encephalitis) and hydrocephaly (when fluid retention around the childhood brain) (Roe 2004), but all this is very rare.

Your doctor will refer you to an urogenital medicine specialist and you will be given a 5-day antiviral therapy, mostly acyclovir. The preparation alleviates the symptoms and accelerates the healing of the blisters. It can be used safely during pregnancy.Your doctor will probably also recommend another accurate ultrasound scan in a prenatal center to make sure your baby is fine.

There is a greater risk to your baby if you have your first late-term genital herpes outbreak and your body can not build enough defenses to protect your baby. It may be due to direct contact with active, inflamed or weeping blisters during birth. When that happens, it is called neonatal herpes.

In Germany and even Western Europe this happens very rarely, only once to 15,000 to 40,000 births (Clinic Guide 2008), because most babies are delivered in an acute genital herpes infection of the mother at the time of birth by caesarean section , Otherwise, the risk of infection would be significantly higher - between 40 and 50 percent of babies whose mother has a first outbreak of genital herpes in late pregnancy (Clinical Guide 2008).

Newborn herpes can be very dangerous and even life-threatening. It can cause a skin, eye or mouth infection in the baby, causing damage to the brain or other organs (RCOG 2005). Then you and your baby need anti-viral therapy to prevent or limit long-term health problems.

Will a cesarean section be necessary?

Be sure to tell your midwife or doctor if you suspect you may be suffering from genital herpes in the last trimester of pregnancy. If you've never had herpes before then you'll probably be advised to have a caesarean section for the reasons mentioned above, especially if the first outbreak occurs in the last six weeks of pregnancy. This is to reduce the risk of virus transmission to your baby to a minimum.

If you're not seeing the virus for the first time, you'll probably need to take acyclovir every day for the last four weeks of your pregnancy. You will not be advised to go to the caesarean section because your baby will most probably already have an immune protection.

Can I breastfeed with herpes?

The herpes virus is not transmitted through the breast milk, so you can breastfeed despite herpes, if you have no cold sores on the chest. Make sure that all parts of the body where you have cold sores are covered and wash your hands frequently and thoroughly. For cold sores you should wear a mask during breastfeeding (Clinic Guide 2008). Aciclovir passes into breast milk but is not harmful to the baby (Lee et al 2000, NZHF 2000).

What causes a genital herpes infection?

The symptoms vary greatly from patient to patient. For most sufferers, however, the symptoms are worst during the initial infection and last the longest.The following symptoms may occur in a primary infection:

painful vesicles on the genitals and buttocks

  • itching
  • burning sensation on urination
  • discharge
  • swollen lymph nodes in the groin
  • Flu-like symptoms such as fever, headache and Body Pains
  • A first illness may take two to three weeks (PRODIGY PIL 2005).

In a subsequent infection, the symptoms may be completely absent or affect only a small area of ​​the skin. A follow-up infection usually lasts for three to five days (PRODIGY PIL 2005).

Whether you have symptoms or not, remember to be contagious in the event of an outbreak. In fact, infection is much more likely if the transmitter itself has no significant symptoms. Therefore, be sure to inform your midwife if you or your partner ever had an outbreak in the past.

How do I protect myself and my baby from infection?

During pregnancy, you must be extra careful when your partner is suffering from genital herpes. The virus is also transmitted if your partner does not realize that he has an outbreak, and it is particularly contagious just before or while the symptoms are occurring.

Therefore, there is no safe way to protect yourself from infection. You can get infected with or without penetration (vaginal or anal) during sex, with oral sex or when you use shared sex toys. Condoms can reduce the risk or you completely abstain from sex. Keep in mind that you can get genital herpes even if your partner has cold sores and satisfies you orally.

To protect your baby from infection after birth, you should be careful not to touch or touch anyone who has an acute herpes infection (lips or genitals) - you should not Consider whether it is uncle, aunt, grandma or grandfather.

Ask the person to refrain from physical contact for the safety of your child. If you or your partner suffers from herpes, take all necessary precautions to reduce the risk. Make sure that all parts of the body that have cold sores are covered and wash your hands frequently and thoroughly before touching the baby. For cold sores you should - as hard as it may be you - do without kisses.

Who can help and where is more information?

For more information, contact your doctor or midwife or visit the Robert Koch Institute website.

Sources

Information on herpes virus at the Robert Koch Institute at www. rki. de [January 2009]

Lee A, Inch S and Finnigan D 2000.

Therapeutics in pregnancy and lactation

. Oxford: Radcliffe Medical Press. Low-Beer N. and Smith J.R. 1996. Herpes simplex virus in pregnancy. Maternal and Child Health

, 21 (9): pp 237-240. NZHF. 2000. Guidelines for the management of genital herpes in New Zealand

. 5th Edition. New Zealand: New Zealand Herpes Foundation. PRODIGY PIL. 2005. Genital Herpes

. PRODIGY Patient Information Leaflet 72. Version 30. London: NHS. www. prodigy. nhs. uk [as of July 2006] PRODIGY. 2005. Herpes simplex - Genital

. PRODIGY Guidance. Department of Health. www. prodigy. nhs. uk [as of July 2006] RCOG (Royal College of Obstetricians and Gynecologists) 2005. Genital herpes in pregnancy: information for you

. www. rcog. org. uk [as of July 2006] Tookey P, Peckham CS. 1996. Neonatal herpes simplex virus infection in the British Isles. Paediatr perinate epidemiol

, 10 (4), pp 432-442. Show sources Hide sources

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