Genital herpes, caused by the herpes simplex viruses HSV 1 and HSV 2, affects a significant percentage of people. During pregnancy, this condition can pose concerns and potential complications for both the expectant mother and the unborn child.
Can you pass genital herpes to your baby during pregnancy? The answer is, unfortunately, yes.
Genital herpes can indeed be transmitted from a mother to her baby if the virus is present in the woman’s birth canal during the delivery. The condition is known as neonatal herpes, which is a very rare but severe illness.
However, not all babies born to mothers with genital herpes will contract the virus. Even more reassuring, most women with genital herpes give birth to healthy babies!
What is Genital Herpes?
Genital herpes is a chronic viral infection caused by the herpes virus (HSV). The most known HSV viruses are HSV type 1 and type 2.
Historically, the herpes simplex virus type 1 (HSV-1) has been primarily associated with causing oral herpes, often seen as cold sores or fever blisters around the mouth. On the other hand, herpes simplex virus type 2 (HSV-2) has been more commonly linked to genital herpes.
However, due to shifts in sexual behaviors (such as oral-genital contact), HSV-1 has increasingly been found to cause genital herpes as well. This shift means that HSV-1, traditionally associated with oral sores, can now also be a cause of genital herpes.
It’s important to note that both HSV-1 and HSV-2 can cause either oral or genital herpes, although they have traditionally been associated with different locations!
Transmission and Manifestation
Genital herpes is a sexually transmitted condition that is transmitted through body fluids (genital secretions and saliva).
Herpes infection manifests as blisters or sores around the lips, nostrils, and genital area, inflammation of the cornea and eyelid, or, in rare cases, an inflammation of the brain membrane (meningoencephalitis).
However, in many cases, genital herpes is not recognized. This means patients can excrete viruses even when they do not have characteristic painful blisters and wounds.
Signs of Genital Herpes in Pregnancy
Signs of genital herpes during pregnancy differ between initial (primary) infections and recurrent outbreaks. Primary infections often manifest as painful blisters, ulcers, and other systemic symptoms, while recurrent outbreaks tend to be milder.
Symptoms of the primary infection:
- Changes in the external genitalia in the form of tiny painful blisters
- Genital ulceration
- Vaginal discharge
Other signs of genital herpes in pregnancy:
- Affected area may experience itching, pain, or irritation
- Pregnant woman usually feels a burning sensation when urinating
- General malaise
- Enlarged lymph nodes in the groin
- Muscle and joint pain
Recurrent genital herpes may occur several times a year. The clinical picture is milder, the changes are less intense, and there is usually no overall tiredness.
Pregnant women experience less significant signs. For example, only a slight pain in the external genital area may be present.
Treatment of Genital Herpes in Pregnancy
Managing genital herpes during pregnancy involves careful consideration and potential intervention to protect both the mother and the baby.
It is increasingly recommended for pregnant women who are infected with genital herpes to receive antiviral therapy during the last month of their pregnancy. This treatment can help prevent the recurrence of the infection until delivery.
If you suspect you have genital herpes and you are pregnant, talk to your gynecologist, obstetrician, or midwife! Your doctor can confirm the diagnosis and prescribe antiviral treatment if needed.
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HSV 2 Risks for the Baby
The risk to the baby from genital herpes varies depending on when the mother contracts the infection during her pregnancy.
1. Primary infection:
The most dangerous to the baby is the primary herpes infection in late pregnancy. That is because newly infected pregnant women don’t have antibodies against the virus, and there is no natural protection for the baby during birth.
If a pregnant woman gets genital herpes for the first time in late pregnancy, the risk of transmission to the fetus during delivery is between 30% and 50%.
If the patient becomes ill before pregnancy or in early pregnancy, the risk of transmission to the fetus is only 1 percent!
2. Secondary infection:
Secondary infection is usually only treated if it occurs in the last weeks of pregnancy.
3. Active disease during delivery:
The risk for the baby is the biggest if the herpes simplex virus is excreting from vesicles or ulcers during labor. That is why, in the case of a fresh infection or relapse at the time of delivery, where visible blisters on the vagina, cervix, and rectum are present, the birth with a Cesarean section is advised.
Cesarean section significantly reduces the possibility of transmission to the baby during delivery and prevents the disease in the newborn.
Genital Herpes and Newborns
Newborns affected by genital herpes may display various symptoms, from skin lesions to severe systemic infections, emphasizing the importance of prompt medical attention.
The least dangerous infection for a baby is herpes, which is limited to the skin, eyes, and oral cavity. But it may repeat several times during the first year.
Complications in Newborns:
Unfortunately, HSV 2 can lead to severe conditions in infants, where their central nervous system may be affected. A baby with herpes can lose consciousness, have convulsions, or vomit frequently. This form of illness is associated with high mortality or subsequent disability (cerebral paralysis).
Frequently Asked Questions about Genital Herpes in Pregnancy
How should a pregnant woman care for her hygiene if HSV 2 restarts?
Hygiene is the same for both pregnant and non-pregnant women. Use warm water with occasional use of mild intimate or baby soap. Wear ordinary cotton linen that you can wash at high temperatures.
Be careful that you don’t transmit blister discharge to the other body parts. If contact does occur, immediately and thoroughly wash your hands to avoid transmission.
Can herpes affect a baby in the womb?
Transmission of genital herpes infection via the placenta on the baby is extremely rare.
Is the Caesarean section the only efficient solution for preventing the HSV 2 transition to the baby?
In the case of visible blisters and wounds, the Cesarean section is the safest solution for the baby.
Can the genital herpes virus be transmitted to the baby during vaginal delivery if the pregnant woman is not experiencing a herpes outbreak at that time?
When a pregnant woman has no visible herpes vesicles, the likelihood of transmission from mother to infant is very low (1%).
Can genital herpes (HSV 2) cause a miscarriage?
Although it is extremely rare, it is possible. Researchers have found that there is a slightly higher likelihood of miscarrying, giving birth to a baby with birth defects, or premature birth.
Suppose a woman gets genital herpes for the first time during pregnancy. In that case, the chances of a miscarriage or premature birth are higher than if she already has recurrent genital herpes, but still very rare.
Is genital herpes curable?
No. Once a person gets the herpes simplex virus, they remain infected throughout their whole life. The immune system limits infection, but the virus stays in the body. After some time, it may erupt again, particularly with weakened immune resistance, increased stress, period, etc.
What are the chances of getting HSV 2 from protected sex?
Since the locations of herpetic changes may be outside the area covered by the condom, a genital herpes infection is possible despite the use of a condom.
Condoms, when used correctly and consistently, reduce the risk of virus transmission by 40-70 percent. Your partner is less infectious when they have no rashes.
There is no 100% protection against genital herpes transmission!
What happens if genital herpes is left untreated?
Untreated genital herpes can lead to increased outbreak severity and frequency, causing recurring, painful sores in the genital area. Without proper management, the virus remains highly contagious, easily spreading to other body parts or sexual partners through skin-to-skin contact.
Additionally, untreated herpes may weaken the immune system in the affected area, raising the risk of catching other sexually transmitted infections.
Rarely, it can lead to severe complications like meningitis or encephalitis, affecting the brain and nervous system. Thus, seeking medical advice is crucial for proper treatment. It can manage symptoms, reduce outbreak frequency, and minimize transmission risk to others.
Are the chances of getting genital herpes from my partner smaller over time?
The chance of infection does not decrease over time. More likely, both partners are already infected, so the number of visible relapses is lower.
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