Herpes and Pregnancy | What Are the Risks?

Herpes and pregnancy is of substantial concern because of the potential complications of genital herpes that the HSV-2 virus can cause when transferred to the infant, most often during childbirth when the newborn comes in contact with the virus as it passes through the birth canal. Because infants very early in life have not yet developed an adequate immune system, exposure to the herpes simplex virus (either HSV-1 or HSV-2) can be quite devastating. Without such natural defenses, the virus can make its way into the brain tissues, and then spread to the rest of the body. Before effective anti viral medications were available, newborns who contracted the disease usually died. Now, when new medications are used, the death rate is down to 5% or so, but even still, brain damage can occur. That is why that it is critical to prevent transmission of the disease to newborns if at all possible. This is much more likely today due to the availability the new serologic assays that identify the antibodies, when herpes and pregnancy is suspected. Unfortunately, women who newly acquire HSV infection very late in pregnancy suffer the highest risk of transmission to their newborn because the test may have earlier proven negative, or the antibodies may have not had time to adequately develop.

Herpes and Pregnancy - If You Already Have Herpes

If you have had a history of herpes prior to pregnancy, the risk of passing it on to your infant will be relatively low, provided that you do not have an active outbreak during childbirth. Those long standing cases of herpes evidently are able to pass along antibodies to the fetus which improve their resistance to the disease. Regardless, most doctors knowing in advance about your herpes and pregnancy situation, will take a culture to help insure that asymptomatic viral shedding is not occurring, as a small number of women may be shedding at delivery, which could cause transmission to the newborn. When active herpes infection symptoms or shedding are present at the time of delivery, your child will be safest if delivered by cesarean section. This is the best way to protect your child from the active virus that is likely present in the birth canal during a herpes outbreak.

If You Do Not Already Have Herpes

It is important to be particularly careful to avoid acquiring herpes, of you have no history of infection. The risk of transmitting the disease to your child is substantially higher for those who acquire the disease during pregnancy. The reason being that viral shedding is substantially higher during the the first few months after a primary HSV infection. In addition, the immune-suppressive system of the mother is not sufficiently developed to pass along effective resistance to the fetus. Women without infection, but who have a partner with HSV-2, are at high risk of acquiring the disease during pregnancy, and of transmitting it to their infant. Thus you should certainly use condoms for intercourse at any time during pregnancy, and abstain altogether during your partner's outbreaks. Your doctor may recommend total abstinence during the last trimester, in any case, as that is the time of highest risk for acquiring a primary genital herpes infection, and passing it along to your infant. Finally, the HSV-1 (oral herpes) virus can be acquired genitally through oral-genital sex from partners with a history of oral cold sores or fever blisters. Thus, avoidance of oral-genital sex is also recommended during pregnancy.

Herpes and Pregnancy - If You Acquire Herpes During Pregnancy

Those women who suffer the acquisition of primary herpes while pregnant should be treated with anti viral medications to suppress the disease. Whether or not a cesarean birth should occur is up to the judgment of your physician. You certainly need to fully consult with your medical practitioner on all of the available options for treatment.

Newborns with HSV-2 Infection

The signs of herpes in newborns include skin sores or lesions, poor appetite and listlessness. Prompt treatment is imperative to avoid potential damage to the brain and nervous system. The child's life may be at risk as well. However, cases of herpes infections in newborns remains rare, even though it is estimated that one of every three women of childbearing age has the HSV-2 virus in their system. Statistically, less that one in every 2000 children born of women harboring the virus becomes infected. Regardless, early identification of who is most at risk is important to minimize the inherent risks of herpes and pregnancy,

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