Many people are familiar with herpes. And it’s not surprising, as more than 90% of people on Earth carry this virus. It can be present in the body for 5, 10 and 20 years, without any effect, because the human body in a normal, healthy state usually suppresses the virus. But with decrease in immunity, the herpes virus can become more active. Unfortunately, it is impossible to completely get rid of it. Even the newest drugs can only temporarily suppress its activity – until the next decrease in immunity: colds, diseases, hypothermia, exhaustion, etc. Pregnancy is also included in the list, because herpes often begins to progress during pregnancy, even in those who previously did not know about its presence in the body. So, what should one be aware of about herpes and pregnancy?
Types of Herpes
The disease is caused by herpes virus type 1 (HSV-1, or lip sore) and type 2 (HSV-2, or genital herpes).
Type 1 herpes causes ulcers around the mouth and on the lips (wheals that are popularly called “a cold”). Type 2 herpes causes ulcers in the genital area or rectum, sometimes in other places, but always below the waist. These bubbles burst with time, leaving painful ulcers, which are healing long enough: from 2 to 4 weeks. Even after wheals and ulcers disappear, the virus still remains in the body and can appear again at any time. The same bubbles may appear at the same places.
Lip sore can be transmitted by kiss, airborne and by household contacts. Genital herpes is transmitted by unprotected sex. It is less common, but every fifth adult person is infected with genital herpes, and most people do not even know about it. This type of herpes is often asymptomatic or its symptoms can be taken as manifestations of some other disease.
Herpes and Pregnancy
As we have already mentioned, very often the herpes manifests itself during pregnancy, when the woman’s immunity significantly decreases. By the way, this happens not because the body “weakens”, but for the preservation and bearing of the fetus, which in fact is an alien object for the maternal organism. If the mother’s immune system worked at full strength, the fetus would simply be rejected. Therefore, a decrease in immunity during pregnancy is a real necessity. At the same time, it is a very favorable moment for the exacerbation of herpes.
In case a woman notices a herpetic eruption on the lips, nose, skin of the face or mucous membrane of the genital organs, the doctor will necessarily prescribe an additional examination in order to identify the type of herpes virus that has penetrated her body. Herpes simples is not so terrible, while genital herpes in pregnancy can lead to serious complications. An analysis of herpes and pregnancy is either a study of a tissue sample taken from a site affected by a rash, or, more commonly, a blood test.
Genital Herpes and Pregnancy
The infection can be transmitted by household way or during childbirth (from mother to child), but most often this kind of herpes infection occurs because of unprotected sexual intercourse. Note also the fact that often herpes is accompanied by other infectious diseases of the genital tract: mycoplasmosis, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. Therefore, if a virus of genital herpes is found in the body, it is necessary to undergo a screening for the detection of sexually transmitted infections.
What Are the Symptoms of Herpes Infection during Pregnancy?
Be sure to consult a doctor if you notice the following symptoms:
- vaginal discharge – slight, watery, lasting 5-7 days (sometimes in pregnant women this is the only symptom of this pathology);
- rashes on the skin of the external genitalia, as well as on the walls of the vagina and the cervical membrane. These rashes resemble small bubbles filled with a clear liquid that burst after 2-3 days, leaving ulcers that do not heal within 7-10 days, and sometimes this period reaches up to 2 weeks;
- itching, burning sensation – it often appears before the rashes themselves and serve as their precursors;
- pain in muscles, headache, general malaise and weakness, fever to 38-39 degrees C.
Herpes Simplex during Pregnancy
Such herpes passes 4 stages of development. On the 1st stage there is itching or discomfort in the area of the lips, nose or other areas of the face, perhaps a general malaise and even a fever. On the 2nd stage there is inflammation, characterized by a slight swelling and tenderness of the lips. Eventually it expands and occupies a large surface.
At the third stage, herpetic vesicles burst. As a result, a liquid flows out (containing a large number of viral embryos, and therefore very dangerous in terms of infection). On the place of the bursting of vesicles, wounds are formed. The fourth stage is characterized by the formation of scabs (crusts) on place of the wound. If you touch them with your finger, you will feel pain, and sometimes a little bleeding.
Herpes and Pregnancy: Consequences for the Baby
What is so dangerous about herpes and pregnancy? The greatest danger lies in the high probability of infection of the unborn child. The virus penetrates in various ways: with blood flow through the placenta, from the vagina through the cervical canal, or from the uterine tubes from the pelvic cavity. Also there is a risk of infection of the newborn during childbirth. Particularly severe consequence for the child is the acute course of the disease in the first trimester of pregnancy.
The main complications that the herpes virus can cause in the period of gestation are the following:
- Violation of the development of the child. Herpes in early pregnancy can cause severe fetal development anomalies and spontaneous miscarriage.
- Herpetic lesion of tissues and organs. The most vulnerable are the nervous system, eyes and the mouth of the baby.
- The damage of the placenta and amniotic fluid. This provokes premature birth and hypoxia of the fetus and is found in the 2nd trimester or in the 3 trimester of pregnancy.
- Intrauterine fetal death. Most often it is observed in the first trimester of pregnancy.
- In addition, in the acute period of herpetic infection, the condition of most pregnant woman worsens. It is known that during the gestation of the fetus the immune defense of a woman is physiologically reduced, which makes it more vulnerable to various infectious agents.
Therefore, in case of a combination of herpes and pregnancy, the disease is much more difficult, often with fever, a violation of blood microcirculation (including in the placenta) and dishormonal disorders. This further worsens the nutrition of the fetus, causes hypoxia and delayed development.
Herpes and Pregnancy: Complications
During the gestation period, all the forces of the body are directed to internal restructuring. The resulting decrease in immunity in this case is a favorable factor for the manifestation of a disease. The combination of herpes and pregnancy can be extremely dangerous. That’s why it should not be left without attention. The virus can provoke not only a spontaneous miscarriage, but can also cause serious developmental malformations of the fetus.
First of all, herpes affects the course of pregnancy itself. As a result, the following complications can occur:
- missed miscarriage;
- spontaneous termination of pregnancy;
- premature delivery;
Complications of the baby’s development:
- cardiac anomaly;
- delay in development;
- prolonged jaundice;
- defeat of the central nervous system;
- hemorrhagic syndrome (external and internal bleeding);
- micro / hydrocephalus;
We want to emphasize that the probability of infection of the fetus with the herpes virus during pregnancy is low. The exception is the primary infection of the mother with HSV-2 (genital herpes), when the risk of transmission of the virus to the fetus is 50%. The exacerbation of chronic herpes, accompanied by the release of the virus into the bloodstream is also possible.
Herpes virus causes a lesion of the nervous system in 35% of cases in the newborn, skin and eyes in 45% of cases. It may even lead to disability or death. In conditions of incomplete pregnancy, perinatal mortality occurs in 90% of cases. Placental infection can occur at any time. So the infection with herpes in the first trimester leads to the development of heart defects, hydrocephalus, and anomalies of the development of the gastrointestinal tract. Infection in the 2nd and 3rd trimester causes herpetic hepatitis, anemia, pancreatitis, pneumonia, sepsis, hypotrophy, and herpetic meningoencephalitis.
At primary infection after 32 weeks the child is most often born with ulceration of the skin, cerebral necrosis, cataract, chorioretinitis, microphthalmia. In severe lesions (sepsis, meningoencephalitis), a fatal outcome occurs in 50-80% of cases, with timely treatment, this indicator is reduced to 20%.
Treatment of Herpes during Pregnancy
Since most of the antiherpetic drugs used in medical practice exert a toxic effect on the fetus, the treatment of herpes during pregnancy should take place only under the supervision of a medical specialist. Most doctors recommend using active medication only during the relapse of the disease.
To eliminate eruptions in the perineum and vulva, local forms of antiherpetic drugs (ointment, cream, gel) are allowed. According to the indications, the doctor can appoint pills or injections.
The safest means for pregnant women with proven efficacy is Acyclovir (Zovirax). It can be used either topically or in the form of pills and injections.
Self-medication and home remedies are not allowed in the combination of herpes and pregnancy. This may lead to dangerous complications for the mother and the unborn child.
Herpes and Pregnancy: Preventive Measures
There is a number of measures that allow, albeit not with a 100% guarantee to protect yourself from infection with the herpes virus, and, if possible, prevent it:
- Strengthening the immune forces of the body. It includes not only the reception of immunostimulants, but also a healthy lifestyle, sport exercise, and a proper diet;
- Rejection of all bad habits;
- A blood test for the herpes virus before pregnancy, during the conception planning period.
All these measures are aimed only at strengthening the immune defenses of the body and have an indirect, preventive value.
If you suffer from herpetic rashes quite often, it is recommended to drink a course of multivitamins or immunomodulatory drugs before conception of the child. There is also a special procedure – intravascular irradiation of blood with a laser. Still, even this procedure is not able to kill the virus completely, but only to suppress its activity. This procedure is now offered by many clinics.
If you are not infected with the herpes virus, pay especially close attention to sanitary precautions: direct prevention of infection with the herpes virus is to avoid contacts with infected people.
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