Genital Herpes and Your Baby

Having a herpes infection during pregnancy can cause any pregnant woman anxiety. Will your baby be born with the infection? What kind of complications occurs to an infant with herpes? And is there anything you can do to prevent your baby from being infected?

What is Herpes?
Herpes is a viral infection that is spread through direct contact with herpes sores. There are two types of herpes virus: Herpes Simplex Virus 1 (HSV-1) and Herpes Simplex Virus 2 (HSV-2). HSV-1 has traditionally been associated with causing oral herpes. This type of herpes is marked by cold sores around the mouth area. HSV-2 is the main cause of genital herpes and is spread through vaginal and anal sex. However, HSV-1 can also be transmitted through oral sex, causing a genital herpes infection. There is no cure for herpes.

Genital Herpes Symptoms
The most common herpes symptoms are herpes bumps or lesions. These blister-like sores can appear around the anus, on the penis, on the thighs or buttocks, or in and around the vaginal area. These sores may be accompanied by pain, muscle aches, headaches and fever. Because many women develop vaginal herpes, that is, herpes sores in the vagina, female herpes symptoms can also include vaginal discharge. Unfortunately, this can lead to a misdiagnosis of a yeast infection or pelvic inflammatory disease instead of recognizing the symptoms of herpes for what they really are. Sometimes, boils are confused with a herpes infection. If you have boils, they will be much larger than herpes blisters. Seek appropriate boil treatment.

Herpes and Pregnancy
While being infected with genital herpes, regardless of whether it is caused by herpes type 1 or herpes type 2, does increase your risk of miscarriage and premature labor as well as complications with your baby, it is important to note that very few women with herpes do experience problems. Between 20% and 25% of all pregnant women are infected with genital herpes. Of these, only 0.01% or fewer will experience complications during their pregnancy as a result of their herpes infection.

If you become infected with the herpes virus during the first or second trimester of your pregnancy, it is unlikely that your baby will be affected. This is due to the fact that your body produces antibodies to the HSV-2 virus, which are then passed on to your baby thereby offering her some protection. Women who were already infected with herpes prior to pregnancy will produce these antibodies during pregnancy as well. While your body will also pass on antibodies to your child if you are infected with the HSV-1 virus, these antibodies are not thought to offer as much protection from the herpes virus.

Women who become infected with herpes during their last trimester and/or experience their first episode of genital herpes late in pregnancy are the most at risk of experiencing complications. This is because few, if any, antibodies have time to be passed on to your baby before birth. The biggest risk of herpes transmission to an infant occurs when a mother experiences a herpes outbreak at the time of delivery. As the child passes through the birth canal, the newborn is exposed to the herpes sores. About half of all newborns born vaginally to a mother with a herpes outbreak will be infected with the HSV virus.

Other factors that can increase a fetus� risk of herpes infection include being born prematurely (as these babies will not receive a "full dose" of antibodies at the time of their birth) and using medical instruments during a vaginal birth (which may puncture the child�s skin making it easier for the virus to enter the body). Although it is rare, it is also possible for the herpes virus to be passed through the placenta to the fetus. This is known as congenital herpes.

Herpes Treatment
Because the typical herpes treatments are not necessarily suitable for pregnant women, typical genital herpes treatment in pregnancy involves extra monitoring by your health care professional. So long as you do not have a herpes outbreak at the time of delivery, it is generally thought to be safe to have a vaginal birth.

Herpes medication that can help suppress the symptoms and frequency of herpes outbreaks are generally not suitable for use during pregnancy. Some pregnant women, though, may be prescribed acyclovir during their third trimester to help suppress an outbreak. However, this drug has not been approved by the FDA as safe to use during pregnancy and is classified as a type B drug. This means that is only recommended for use when the benefits of the drug outweigh the risks. The long-term effects of this drug on the child have not been properly evaluated and more study is needed. Of the few tests that have been done, though, all have shown the drug to cause no ill side effects in the child or mother.

If you have a herpes outbreak at the time of birth, a cesarean section will be done to minimize the risk of transmission. If your outbreak occurs shortly before you expect to deliver, your health care provider will closely monitor you and evaluate how infectious you are. So long as you do not have any herpes lesions or viral shedding, a vaginal birth is generally thought to be okay.

Sometimes, herpes are confused with vaginal warts. Vaginal warts are cauliflower-like growths that appear around the genitalia. They are caused by another virus, called the HPV virus. Vaginal warts treatment is available.

Effects of Herpes in Newborns
While few newborns are ever actually infected with the HSV virus before or at the time of birth, those that are can develop serious complications. The herpes virus can affect the child�s internal organs as well as central nervous system. If left untreated, the infection can prove to be fatal. For the small percentage of children that do survive, the virus can affect their eyes or lead to severe mental and developmental retardation. Even a local infection of the skin, eyes or mucus membranes can lead to more serious complications if it is not treated.

Any newborn that is thought to be at risk of a HSV-2 infection should receive a herpes test 24 to 48 hours after his birth. If an infection is suspected or confirmed, intravenous treatment with acyclovir should begin right away. The treatment can last between 10 and 21 days depending on the severity of the infection.

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Concerned about herpes? Visit our Pregnancy Complications forum to discuss the issue with other women.


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