Genital Herpes in Pregnancy

Genital Herpes is a viral infection that spreads through sexual contact.

The two viral strains can cause genital herpes:

  • HSV-1, which is known for causing cold sores, can also produce genital lesions (blisters or open sores).
  • HSV-2 (herpes simplex virus) is the most common and typically spreads through sexual contact.

Herpes is generally manageable in adults. However, a mother can infect their baby during delivery which can lead to serious complications for the newborn.

Herpes infection occurs in less than 1% of births, but it can cause severe illnesses in newborns such as:

  • Seizure
  • Blindness
  • Deafness
  • Viral meningitis

How do you manage Herpes during pregnancy?

Firstly, it is always good to share a detailed history about your background like medical and sexual history to your doctor. By doing this, the doctor can take extra precautions to reduce your baby’s risk of infection during pregnancy and delivery. If you are concerned about your privacy, you can always request the doctor to not discuss this in front of your partner during your appointment.

Although there is no evidence as of now to prove that pregnancy causes flare ups, ACOG says 75% of pregnant women who are exposed to herpes can expect to have an outbreak during pregnancy.

Signs and symptoms to watch for during pregnancy

During pregnancy, you should watch for symptoms of the virus becoming active, such as tingling, itching, malaise, or burning around where the sore will eventually appear.

What are the medications which will be given if you have exposure to the virus?

If you have a history of herpes (or your blood test is positive), your doctor will prescribe an antiviral medication such as acyclovir (Valtrex) to reduce the risk of spreading the virus or having an outbreak around the time of your delivery. It is recommended to start medication (suppression therapy) at 36 weeks or sooner if you are at risk for preterm birth. Antiviral medications are safe during pregnancy. 

Can you have a normal vaginal birth if you have Herpes?

This is a common question asked by individuals who are pregnant or planning for pregnancy. The good news is genital herpes is not an absolute indication of C-Section.

After careful examination, once you are in labor if you have no symptoms and sores around the genital area vaginal delivery may be safe.

It is important to know that C-section can’t completely prevent herpes transmission, but it can decrease the risk to your baby if you have a lesion by preventing direct contact with the vagina and labia.

It is important to note that while C-section delivery is indicated in women with genital lesions, the presence of non-genital lesions is not an indication for cesarean delivery. This includes lesions on the buttocks, thighs or back. It is, however, recommended that these lesions be covered.

How can you protect your newborn from getting Herpes?

If your partner has herpes and you don’t, do not have sexual intercourse in the last few weeks of pregnancy. Condoms can reduce the risk of transmission, but it is not 100% effective. There’s no reason to risk a new infection close to delivery.

In the unlikely event your baby has been exposed, your baby will be treated with antiviral medications. HSV can’t be passed through breast milk, so unless you have sores or lesions on your breasts, breastfeeding is completely safe.

Please consult your doctor if you are unsure about this infection, especially during pregnancy or if you are planning for pregnancy. Pre-marital or prenatal screening for STI will definitely help to prevent complications caused by this infection.

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