Genital herpes is prevalent in Canada and is seen to affect 19% of the population. Approximately 17% of pregnant women in Canada have genital herpes. Two strains of herpes simplex virus (HSV) can cause genital herpes, HSV-1 and HSV-2.  But HSV-2 is the most common cause and spreads through sexual contact. On the other hand, HSV-1 mainly causes oral blisters.

Genital herpes is manageable in adults. However, an infected pregnant woman can pass the infection to the child during delivery, which can cause severe complications in the newborn.

Fortunately, herpes infection affects less than 1% of pregnancies.

If you are pregnant and have genital herpes your doctor will carefully examine you for symptoms before the delivery. If they find any signs of an outbreak, you will be advised to have a cesarean section instead of a normal vaginal delivery to prevent the risk of transferring the infection to your child.

The risk of infection depends on when you are infected. If you are recently infected with genital herpes, the risk of transmission to the baby is about 30%-50%. This is because your immune system has not developed antibodies against the virus. 

With an older infection, you already have antibodies, lowering the risk of transmission and protecting your baby. If you are pregnant and think you may be infected with genital herpes, it is best to consult your doctor right away.

Read on to know more about herpes and how it may affect your baby if you are pregnant.

Causes of Herpes

A newborn can get infected in the following ways:

  • In the uterus, which is unusual
  • During delivery, while passing through the birth canal
  • After birth

If you have an active outbreak of genital herpes during delivery, the baby is more likely to be infected. Some mothers are unaware of the herpes sores in the vagina.

Besides, some mothers may have a past infection but are unaware and may pass the virus to the baby. HSV-2 infection is the most common cause of herpes in newborns. However, HSV-1 infection may also occur if an infected person kisses the baby.

Symptoms of Herpes in the Baby

Herpes mainly causes skin infection. Sores, which are small, fluid-filled blisters, are the commonest symptom of herpes infection in the newborn. These blisters break, crust over, and gradually heal. Sometimes, a mild scar may remain at the site of infection.

In rare cases, the infection can also spread to other body parts, such as the brain, lungs, liver, and kidneys. 

If the infection spreads to other parts, the newborn may get very sick and have symptoms such as:

  • Bleeding easily
  • Fluid-filled sores in the skin
  • Breathing difficulties
  • Weakness
  • Yellowing of the skin and whites of the eyes
  • Poor feeding
  • Low body temperature
  • Seizures
  • Coma or shock

Infected Before Getting Pregnant

Herpes is a common infection and is a silent condition in most cases. So, it may be possible that you have the virus in your body, but you are not aware of it. 

But having the infection before getting pregnant does not have any risk to the newborn. The reason being your body has time to make antibodies, which protects the baby. According to experts, the risk of transferring the infection to your baby is only 1%.

Infected While Pregnant

Herpes during pregnancy needs some management. If you have an initial outbreak during pregnancy, the risk of passing the infection to your baby is higher. 

The baby may be born prematurely or may even die. However, if you have had an infection before, and this time it is just a recurrence, the risk is less unless you have genital sores at the time of delivery.

You can follow the mentioned precautions to hasten the healing process and lower the risk of spreading the infection to other body parts or other individuals:

  • Keep the sores dry and clean
  • Avoid sexual contact unless you are completely healed
  • Do not touch the sores
  • Clean your hands with soap and water

The Risk of Infecting the Baby

The risk of infecting the baby is significantly high if you get genital herpes late in the pregnancy. As discussed above, you do not develop antibodies and thus cannot protect your baby from the herpes infection.

The new infection is active in most cases, increasing the risk of the virus being present in the birth canal during the delivery.

However, women who have a herpes infection before becoming pregnant have an extremely low risk of transmitting the infection to their kids. Mothers already have antibodies that pass to the baby through the placenta, protecting the baby from the infection.

Although not common, herpes can also be spread to a newborn if someone with oral herpes kisses them. In rare instances, herpes may also spread through skin contact when someone with oral herpes touches the blister and then touches the baby.

Simple precautions such as washing hands, not touching the sores, and not kissing the infant can prevent its spread.

How to Avoid Getting Herpes While Pregnant?

You can take the following precautions to avoid getting herpes:

  • Avoid sex during the third trimester unless you know that the partner does not have a herpes infection
  • Avoid oral sex if your partner has oral herpes

Some experts believe that all women should be tested for herpes when pregnant. This is crucial if the partner has herpes. If you are not sure, consult your doctor to know if you should be tested or not. 

Diagnosis

The doctor may advise the following tests to confirm herpes in the baby:

  • Scraping the vesicle or send for vesicle culture
  • MRI of the head
  • EEG
  • Spinal fluid culture

Some additional tests include:

  • Complete blood count
  • Coagulation studies
  • Electrolyte measurements
  • Liver function tests
  • Blood gas analysis

Treatment During Pregnancy

To date, there no cure for herpes. If you are infected, you will have the virus in the body throughout your life. However, antivirals can prevent the risk of transmission and lower the recurrence of outbreaks. Some options are:

  • Valacyclovir (Valtrex)
  • Acyclovir (Zovirax)

While the medicines are safe and are not seen to increase the risk of birth defects, it is best to consult your doctor before taking them. If you are pregnant and have genital herpes, the doctor may prescribe daily doses of antivirals for the month before your due date.

Precautions

As discussed before, you can do the following to reduce the risk of transmitting the virus:

  • The virus can easily spread through body fluids. So, avoiding sex when you have an active infection with symptoms such as blisters or sores
  • Use a barrier method of contraception, such as a condom, even when you are free of sores

Once the virus enters your body, it lies in a dormant stage in the nerve cells. Certain factors such as surgery, exposure to the sun, fever, illness, or stress may trigger an infection. If any of the factors are known to trigger an outbreak, it is best to avoid them. You can take the help of your doctor to know measures to prevent frequent outbreaks.

Delivery Precautions

If you are symptom-free and do not have sores, it may not affect your plans for labor. The risk of transmission occurs only when the baby comes in contact with active sores during birth. If you have active sores, your doctor may advise a c-section.

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