Congenital And Neonatal Infection
Itis necessary to distinguish between congenital infection and neonatal infection with HSV. In fact, HSV infection of the newborn can be acquired during pregnancy, intrapartum and postnatally. The mother is the most common source of infection for the first two routes of viral transmission. Congenital infection is very rare due to the acquisition of the virus in utero it comes to the neonatal HSV infection when the appearances of the lesions are more than 48 hours after birth .
Intrauterine HSV infection accounts for 5% of HSV infections in neonates. The highest risk of intrauterine infection has been observed in pregnant who develop disseminated HSV infections and 90% of those are related to HSV-2. Both primary and recurrent maternal infection can result in congenital disease, even if the risk after recurrent infection is small.
Intrauterine viral transmission is highest during the first 20weeks of gestation leading to abortion, stillbirth, and congenital anomalies. The perinatal mortality is 50% .
In 8590% of neonatal HSV infections, HSV is acquired at the time of delivery and 510% are caused by early postnatal viral acquisition. A percentage of 7085% of neonatal HSV infections are caused by HSV-2, whereas the remaining cases are due to HSV-1. The HSV-2 infection carries a graver prognosis than that caused by HSV-1 .
The disease transmission to the newborn is dependent on the type of maternal genital infection at the time of delivery.
Will I Need A C
Once you go into labor, well carefully examine you for genital lesions. If we see something suspicious, we will recommend a C-section.
If you have no symptoms and no sores in the genital region, a vaginal delivery may be safe. Lesions can sometimes appear in other areas, such as the legs or back. If this is the case, well cover them to make sure the baby doesnt come into contact with them.
How Do I Talk With People About Having Herpes
It might feel scary to admit you have herpes, but talking about things can really ease your mind. You could lean on a close, non-judgmental friend that you trust to keep the conversation private. Parents, brothers and sisters, aunts and uncles, and other family members can also be a source of comfort. Remember, herpes is really common, so its possible the person youre talking to has herpes, too.
There are a lot of online support groups for people who have herpes, and the American Sexual Health Association has a list of support groups that meet in person.
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Treatment Of Herpes In Pregnancy
The recommendation of the American College of Obstetricians and Gynecologists is to treat all primary outbreaks of genital herpes with antiviral medications, including primary outbreaks in pregnant women.
Acyclovir has the most data on the safety of use in pregnancy. A registry of over 1000 pregnant women who were exposed to acyclovir during early pregnancy suggests that acyclovir is most likely safe, as there were no increases in birth defects.
Most women who have a current outbreak of genital herpes, primary or recurrent, are usually advised to have a cesarean section to reduce the exposure of the infant to the herpes simplex virus. However, women with known herpes exposure usually take an antiviral medication in the third trimester to prevent outbreaksâand are able to safely deliver vaginally.
How Do I Know If I Have Genital Herpes
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an outbreak. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
- You notice any symptoms or
- Your partner has an STD or symptoms of an STD.
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods .
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What Are Possible Complications Of Herpes
Theres some research that a genital herpes infection may lead to miscarriage or result in the preterm delivery of your baby, which is why its important to discuss any symptoms you have with your physician so your case can be managed carefully.
If you have recurrent herpes , youre at an extremely low risk less than 1 percent of transmitting herpes to your unborn baby.
Same goes if a routine screening for sexually transmitted diseases at your first prenatal visit diagnoses HSV for the first time, or if youre infected during the first trimester of your pregnancy and are asymptomatic.
Only women who are infected for the first time in late pregnancy have a greater risk of infecting their unborn babies, because their bodies have not yet produced HSV antibodies. In the rare case that a newborn gets herpes, transmission most often occurs when the baby passes through the mothers infected birth canal.
To prevent this from happening, your health care provider may prescribe medication in your third trimester to decrease the chances of a herpes outbreak around the time you give birth. And if you have active sores or youre expecting a breakout near your due date, you might be advised to have a cesarean section to minimize the risk of infection.
Type Of Tests Used To Diagnose Herpes
There are four main types of diagnostic tests that can be used to diagnose herpes. Your doctor will determine which type of test to use based on whether an outbreak is present or not.
If youre experiencing what you believe to be a herpes outbreak, your doctor can use a viral culture test or virus antigen detection test. If youre not experiencing symptoms, you can have an antibody test.
- Viral culture test.This test is used to determine if a sore contains the herpes virus. This test can sometimes produce a false-negative, meaning that it may not detect the virus even though its present.
- Virus antigen detection test. This test is used to determine if antigens to the herpes virus are present in a sore or lesion.
- Antibody test. If youre not experiencing an outbreak yet but still believe you may have been exposed, you can opt to have an antibody test performed. This test will only show a positive result if the antibodies to the virus have been developed. Therefore, this test isnt necessarily recommended for recent exposure.
- Polymerase chain reaction test. With this test, a healthcare provider can screen a sample of your blood or tissue from a sore. They can use this to determine if HSV is present and which type you have.
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Precautions For Pregnant Women Without Herpes
While any woman who has never had herpes should be cautious about having sex with someone who might have herpes, pregnant women should take extra precautions in their third trimester. These guidelines include avoiding intercourse and oral sex with partners who have, or you suspect have, genital herpes.
If you’re uncertain if you’ve been exposed to herpes, consider asking your obstetrician about HSV antibody testing to be sure.
Herpes Simplex And Getting Pregnant
As the second most common sexually transmitted disease, herpes simplex can be quite an obstacle for women preparing to have children. It is estimated that 25-30% of mothers-to-be have genital herpes, which might delay conception and cause complications, such as viral transmission to the baby.
However, despite significant risks, pregnancy complications can be avoided by following proper management recommendations. Keep on reading to find out what effective steps you can take to ensure your baby’s health and to safely transition into motherhood.
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How Does Genital Herpes Spread
Herpes can be spread when an infected person has lesions blisters and open sores on their body or when you do not have any symptoms. Taking antiviral medicine can help you reduce the risk of spreading genital herpes to your sexual partners. You can also:
- Inform your sexual partner that you have genital herpes.
- Use a condom every time you have sex.
- Refrain from having sex when you have symptoms.
- Abstain from performing oral sex if you have blisters or open sores around your mouth.
What Happens If I Dont Receive Treatment
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.
If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? for information about this.
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How Is Hsv Treated During Pregnancy Or Breastfeeding
You can treat cold sores and genital herpes with:
- aciclovir cream, available from a pharmacist without prescription
- aciclovir or valaciclovir tablets, for which you need a prescription
These ‘antiviral’ drugs are known to be safe for pregnant and breastfeeding women and are effective most of the time.
Famciclovir tablets are not recommended to take during pregnancy. Speak to your doctor if the cold sore is severe.
How Can I Manage Herpes During Pregnancy
There is no evidence to suggest pregnancy causes flare-ups. The American College of Obstetricians and Gynecologists says 75% of pregnant women who have herpes, however, can expect to have an outbreak during pregnancy.
During pregnancy, you should watch for symptoms of the virus becoming active, such as tingling, itching, or burning around where the sore will eventually appear.
If you have a history of herpes , your provider may prescribe an antiviral medication such as acyclovir to reduce the risk of spreading the virus or having an outbreak around the time of your delivery.
We typically recommend starting an antiviral at 36 weeks or sooner if you are at risk for preterm birth. The antiviral medications are safe during pregnancy. In fact, we can give the same medications to your baby if needed.
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What Do I Do If I Find Out I Have Herpes
Its normal to have lots of different feelings after you find out that you have herpes. You might feel mad, embarrassed, ashamed, or upset at first. But youll probably feel a lot better as time goes by, and you see that having herpes doesnt have to be a big deal. People with herpes have relationships and live totally normal lives. There are treatments for herpes, and theres a lot you can do to make sure you dont give herpes to anyone you have sex with.
Millions and millions of people have herpes youre definitely not alone. Most people get at least one STD in their lifetime, and having herpes or another STD is nothing to feel ashamed of or embarrassed about. It doesnt mean youre dirty or a bad person it means youre a normal human who got a really common infection. The reality is that herpes can happen to anybody who has ever been kissed on the lips or had sex thats a LOT of people.
Herpes isnt deadly and it usually doesnt cause any serious health problems. While herpes outbreaks can be annoying and painful, the first flare-up is usually the worst. For many people, outbreaks happen less over time and may eventually stop completely. Even though the virus hangs around in your body for life, it doesnt mean youll be getting sores all the time.
And tell anyone you have sex with that you have herpes. Its not the easiest conversation, but its an important one. Here are some tips:
Genital Herpes And Pregnancy: Understanding The Risks
Genital herpes is one of the most common health conditions in the U.S. The Centers for Disease Control and Prevention estimates that 1 in 6 people between the ages of 14 and 49 have it. Approximately 22% of pregnant women in the U.S. have genital herpes. Two percent contract it during pregnancy that’s 1 in 50 pregnant women.
Two viral strains can cause genital herpes. HSV-2 is the most common and typically spreads through sexual contact. HSV-1, which is best known for causing cold sores, can also produce genital lesions . More than half of adults in America get HSV-1 at some point in their lives.
Herpes is generally manageable in adults. However, it can cause serious health problems in newborns. During delivery, your baby may be exposed to the virus, even if you are not having an outbreak.
Herpes infection occurs in less than 1% of births, but it can cause severe illness in newborns, such as:
- Serious infections, such as viral meningitis
- Recurrent sores on the skin, eyes, genitals, or mouth
- organ damage, including to the liver, lungs, and heart
Tell your doctor if you or your partner have herpes or if you may have been exposed. By knowing, we can take extra precautions to reduce your baby’s risk of infection during delivery and in their first few weeks at home. If youre not certain but think you may have had herpes in the past, we can do a blood test to determine whether you have had the infection.
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Why You Should Go To A Sexual Health Clinic
You can see a GP, but theyâll probably refer you to a sexual health clinic if they think you might have genital herpes.
Sexual health clinics treat problems with the genitals and urine system.
Many sexual health clinics offer a walk-in service, where you do not need an appointment.
Theyâll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.
Herpes Usually Doesnt Impact Your Ability To Get Pregnant
“People believe that when they’re diagnosed with genital herpes that their life is over,” says Alexandra. She’s met people through the Life with Herpes community who don’t have sex or date because they’re afraid of passing the virus on, and fear that it will harm their ability to conceive.
The reality, though, is that unlike other STIs like chlamydia and gonorrheawhich, when untreated, can lead to an infection that might potentially damage the fallopian tubes and uterusherpes usually doesn’t impact your ability to get pregnant .
That said, a 2013 study of Iranian men showed that those with HSV-1 had a low sperm count. And 40% of infertility cases are due to male factors, like low sperm count.
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How Is Herpes Treated In Pregnancy
Its not clear whether all antiviral medications for genital herpes are safe during pregnancy, so follow your doctors lead when it comes to treatment.
Herpes symptoms may be managed with antivirals and during an outbreak, and they may reduce the length and severity of it. Daily medication, which is called suppressive therapy, can also reduce the number of outbreaks you experience.
How Long Do Herpes Outbreaks Last
When you hear the word herpes, the image that comes to mind is probably one of a sore at the edge of your lip that crops up every time you have a cold or a fever. But herpes is a little more complicated that that. Believe it or not, most people who have herpes have absolutely no idea. Thats because, for the most part, the virus can be entirely asymptomatic. Usually the first infection when it comes to oral herpes happens sometime during childhood and not from sexual contact, and the symptoms are a lot more like a cold. In severe cases, the initial outbreak can involve a fever, swollen lymph nodes, swollen gums, and sores in your mouth, throat, or on your tongue. An initial herpes outbreak lasts around 14 days but can take up to six weeks for sores to fully heal .
While oral herpes is most commonly caused by herpes simplex virus 1 , genital herpes is more frequently cause by herpes simplex virus 2 .
Much like oral herpes, an initial genital herpes infection can last a lot longer than subsequent outbreaks and may be accompanied by fever and other whole-body symptoms and some symptoms may persist for weeks. Recurrent genital herpes outbreaks cause symptoms like itching, redness, and irritation in the genital area, but like oral herpes, genital herpes can also be asymptomatic . A genital herpes outbreak may begin with pain in the genitals and shooting pains or tingling in your legs, hips, or butt. These symptoms usually occur before you can see any blisters or lesions .
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How Does Herpes Impact Pregnancy
If you contract herpes while pregnant, or if you have herpes before you get pregnant, the diagnosis may impact the steps you take on your pregnancy journey.
A herpes diagnosis can affect pregnancy differently depending on when the virus is contracted:
- Before pregnancy â If you contract herpes before getting pregnant, thereâs a very low risk of transmitting the virus to the baby . This is because herpes antibodies can be passed onto a baby through the placenta. Even so, a healthcare provider may recommend taking antiviral medications during pregnancy to prevent an untimely outbreak on the due date .
- During pregnancy â If you contract herpes during pregnancy, thereâs a greater risk of passing the virus to the baby. This is because the mother wonât have any pre-existing antibodies to pass on. Thereâs also a greater chance of an active outbreak near the birth canal on the due date. If this occurs, you may need to have a C-section to keep your baby away from any blisters or sores during the birthing process .
The good news is that neonatal herpes is rare. According to one study, approximately 1 in 3200 deliveries results in neonatal herpes .
Whether herpes is contracted before or after becoming pregnant, you should let your healthcare provider know about the diagnosis. They can help monitor and manage the infection throughout pregnancy to help ensure the health of you and your baby.
