How are childbirth with genital herpes?
Most expectant mothers begin to experience as soon as they observe the slightest changes in their own health. After all, diseases, viruses and infections can harm the baby. When herpes appears in their lives, anxiety is doubly enhanced. Rashes in the form of ulcers on the lip or genitals appear suddenly for no reason. Let's see how the labor goes during herpes, how dangerous infection of the fetus can be, and how to treat herpes during pregnancy and lactation.
What is herpes, and how can it be?
Herpes is the most common disease in the world, the causative agent of which is the same type herpes simplex viruses of the first type - HSV-1 and the second type - HSV-2. Pregnant women may even encounter them without contact with a sick person. All because the herpes viruses can be in our body for many years and does not manifest itself. The weakened immune system of future and lactating mothers triggers the mechanism of their development.
The area of HSV-1 - the lips and face, the rash of HSV-2 appear on the genitals. HSV-1 is transmitted by airborne droplets, through direct and sexual contact with a sick person, through saliva, semen, cervical secretions. VGH-2 is sexually transmitted. At the same time, women are more susceptible to this disease, especially to HSV-2.
Herpes can be felt before childbirth or immediately after it. The development of the virus is caused first by itching and pain, and then by the appearance of bubbles that look like blisters.
In order to find out whether the herpes on the lips is dangerous for the fetus, it is necessary to delve into its origin. In fact, a pregnant woman can become infected with a disease, for example, even in childhood, and the state of expectation of the baby, when all the forces of the body are aimed at carrying it, brings it into action. Rashes can appear on the lips several times throughout life, however, if during pregnancy the small bubbles “decorated” the future mother's face for the first time - there is some probability that the virus can turn into a real danger for the baby, spreading throughout the body. Secondary rashes are not capable of causing special harm to the health of the fetus. But it is worth emphasizing that if the mother has herpes on the lips and she performs oral caress to her partner, then the rash may appear on the genitals, but HSV-1 cannot transform into HSV-2, these are different viruses.
If we consider herpes during pregnancy on the other hand, it can be argued that during this period, the production of antibodies to the virus by the body occurs not only in the mother, but also in the baby. That is, after the birth, the child will be protected from HSV-1 immunity.
Unfortunately, modern medicine still can not answer the question: "How exactly does the development of herpes in childbirth or during pregnancy affect the health of the fetus?". Therefore, it is better to be safe and cure the disease, or to adhere to the measures of prevention of the virus. But the appointment of therapy should come only from a specialist, because the use of inappropriate drugs can sometimes harm the fetus much more than the disease itself.
Treatment of herpes on the lips during pregnancy
The method of treatment of herpes on the lips during pregnancy differs in some principles:
1. Ointments to eliminate lesions should be used strictly as prescribed by a specialist.
2. Systemic remedies of symptomatic treatment are contraindicated and can be used only in case of urgent need.
3. The repeated appearance of herpes on the lips requires a thorough diagnosis to identify the causes of the decrease in the action of immunity.
Often, experts prescribe ointment on the basis of acyclovir. They practically do not penetrate into the blood and are highly effective. However, even these ointments have contraindications. Therefore, it is worth using them according to the recommendations of the doctor, so that herpes on the lips during childbirth will not spoil your meeting with the baby.
Genital herpes during pregnancy
In most cases, genital herpes in pregnant women proceeds with hidden symptoms, that is, without a rash. And only 1/3 of future mothers are faced with a typical etiology for the virus.
In the latter case, grouped vesicles filled with clear liquid cover the labia, pubic area, anus. This whole clinical picture is accompanied by itching and pain. A few days before this, an infected pregnant woman (more often with a primary lesion) is experiencing body aches, fever, pain in the joints.
In the active phase of the disease, the bubbles burst, forming ulcers, which eventually transform into crusts and disappear from the skin without a trace. It is characteristic that during the exacerbation of herpes rash appears in the same place.
The underlying symptoms are due to the absence of vesicles, but the presence of vaginal discharge, itching of the genital organs, swelling and redness of the mucous membranes. Not surprisingly, many pregnant women confuse this etiology with thrush and begin to self-medicate.
It is worth noting that genital herpes during childbirth and during pregnancy can cause enormous harm to the fetus: starting with pathologies of the placenta, through which the baby eats and develops, and ending with a miscarriage or premature birth of the baby. Therefore, it is very important to start treatment in a timely manner and to observe preventive measures in order to avoid the recurrence of genital herpes before childbirth.
Herpes before childbirth, what to do?
During pregnancy, women donate blood for the presence of antibodies to herpes. They also periodically take smears of vaginal secretions for virological examination. Therefore, to determine the presence of the disease in the body is not a problem, unless the pregnant woman does not neglect the delivery of all necessary tests.
The treatment regimen for genital herpes includes:
1) means of local destination, for example, cream "Acyclovir",
2) antiviral therapy. Excellently proven "Valtrex" during pregnancy,
3) drugs that stimulate the improvement of immunity - immunoglobulin - intravenously or the same candle "Viferon",
4) control cervical scraping for HSV.
Depending on the trimester is determined by the dosage of drugs. On the eve of delivery, in order to avoid recurrence of the disease, pregnant women are recommended to undergo suppressive therapy. It consists in taking "Acyclovir" before childbirth, which provides a high degree of safety for the fetus. The use of the drug throughout the third trimester significantly increases the chances of natural delivery.
Exacerbation of genital herpes before childbirth
During the period of exacerbation of the virus before delivery, the treatment regimen does not change. However, it should be noted that pregnant women during therapy and before it ends should refrain from sexual intercourse, even with the use of a condom. In addition, they should avoid stress, more often be in the open air and take a complex of vitamins.
Childbirth with herpes on the lips
In the forums for pregnant women, many women ask the question: "What to do if herpes appeared on the lips before delivery?". Experts rush to reassure them, there is nothing to worry about. Often, herpes on the lips before childbirth occurs as a result of a cold or ARVI. After all, the immune system during this period is significantly weakened. Births with herpes type I are natural. After all, the rash area is far from the birth canal. But it is important to protect the affected area from the newborn. If herpes during childbirth is of primary nature, it is advisable to examine the baby for the presence of a virus in the body after its birth.
Childbirth with genital herpes
To resort to a different method of delivery of specialists forces genital herpes before childbirth. In this case, only caesarean section is possible. After all, the passage of the baby through the birth canal increases the likelihood of infection with a virus to the maximum values. Pregnant women are prescribed "Acyclovir" tablets before childbirth, which are an additional barrier to infection of the newborn. After all, even the operation does not give a 100% guarantee that the virus will not be transmitted to the baby.
Before choosing a mode of delivery a pregnant woman with a diagnosis of HSV-2 is examined for the presence of lesions. If they are present, the pregnant woman is prepared for surgery. Genital herpes during childbirth requires the accuracy of specialists, as well as careful antiseptic treatment.
Births with genital herpes, by caesarean section - are relevant in the following situations:
- primary infection of the patient in the last month of pregnancy and a small amount of antibodies in the blood to the virus,
- recurrence of herpes before childbirth,
- discharge of HSV on the eve of labor from the cervix,
- the presence of complications during the recurrence of herpes, the resistance of the virus to treatment with the drug "Acyclovir",
- early departure of amniotic fluid, (anhydrous period of more than 8 hours) in the presence of rash and discharge of HSV in the last month of pregnancy.
Operational childbirth is carried out and with acute herpes.
However, the absence of the above indications does not prevent natural childbirth. In this case, specialists conduct preliminary training. In addition to taking "Acyclovir" during childbirth with herpes, women are also treated with an antiseptic solution - chlorhexidine (antiseptic) and antiviral drugs (a solution of poludana). At the same time, the number of vaginal examinations is reduced to a minimum.
Preventing Herpes Before Childbirth
Prevention of herpes during pregnancy before childbirth is carried out 2 weeks before the operation, experts prescribe the use of "Acyclovir" in a suppressive dosage. After all, a cesarean section can not guarantee 100% guarantee that the baby will not be infected with HSV infection during childbirth.
If experts agree with the future mother decide to give preference to natural delivery, immediately after birth, the baby is dug through "Acyclovir" intravenously. In addition, it is isolated until complete recovery of the mother.
Regardless of the type of herpes, breastfeeding is recommended for the newborn, which is a source of antibodies to the mother's infection, even when HSV antigen is detected.
Herpes on the lips after childbirth
Detection of herpes on the lips after childbirth causes panic in mom. After all, many drugs are contraindicated for nursing women because of the risk of their penetration into milk. Therefore, it is so important that the specialist prescribed adequate therapy. Self-treatment in this case is not appropriate.
If a woman has herpes on her lips after childbirth, treatment should begin at the stage of blistering. Often, dermatologists prescribe drying agents. The affected area should be lubricated with a solution of "Fukortsina" or propolis tincture.
Additionally, nursing mothers recommend drugs that strengthen the immune system and the body as a whole. Antiviral drugs are not included in the list of appointments, as most of them can get into the milk and harm the baby. To strengthen the immunity, mothers should stay in the open air more and eat fortified food.
Also mom should make sure that the disease is not transmitted to the baby.
Continuing to perform lactation, you should observe a number of precautions:
1) ensure that the area affected by herpes does not touch the baby’s skin. To do this, for the period of treatment, it is worth refraining from kissing and not giving the opportunity for the crumbs to touch the face with a pen,
2) after handling the rash or any other contact with the affected area, hands should be thoroughly washed,
3) during feeding, you can use a cotton-gauze bandage, which will reduce the likelihood of infection of the baby.
In conclusion, I would like to emphasize that herpes is not a sentence, both during pregnancy and after childbirth. Timely treatment and preventive measures can keep the baby and mother healthy. The main thing - do not neglect the advice of experts.
What is dangerous genital herpes during pregnancy?
Genital herpes is an infectious pathology caused by the herpes virus, which mainly affects people between the ages of 15-45 and is sexually transmitted. The disease is accompanied by a burning sensation and itching in the genital area, a herpetic rash on the mucous membranes, and skin in the genital area. The causative agent of the disease is the herpes virus of the 2nd, less often of the 1st type.
In contrast to the infection that occurs on the lips, herpes in the intimate area adversely affects pregnancy. When infection occurs in the first 3 months of gestation, the risk of miscarriage or the manifestation of dangerous defects in a child increases.
In this regard, at the planning stage, a woman should turn to a consultation for the implementation of a full examination, which includes the diagnosis of the presence of antibodies to genital herpes in the body. The earlier infection agents are detected, the higher the chances of preventing the child from manifesting complications.
In the 2nd trimester, the intrauterine lesion is extremely rare. In 90% of the child is infected during childbirth, when he passes through the infected birth canal. Pathology develops in the first seven days after birth. This affects the skin, mucous membranes, liver, central nervous system. There is a risk of isolated development of a brain infection.
Herpes in a child sometimes occurs without affecting important organs. In case of a mild lesion, typical vesicles form on the skin and mucous membranes, often involving the eye in the pathological process - keratitis or conjunctivitis. Therapy is carried out by a neonatologist in a children's institution.
With recurrent genital herpes, antibodies are transmitted from the mother to the child. Due to this, immediately after birth, the baby’s body has a ready-made immunity, which allows it to overcome infection.
The disease will be more difficult when the primary development of genital herpes occurred during pregnancy. So, the child will need its own antibodies, their development by a small organism is not fast, and therefore the disease is delayed.
What is different from the usual?
If a pregnant woman develops herpes in the intimate area, then it is necessarily accompanied by rashes. The earlier a rash forms before the preliminary date of delivery, the better. During natural childbirth ulcers near the vagina must be closed with a bandage with an antiseptic. Well, when the sores are already covered in crusts - in this case, the virus will not affect the newborn.
If the rash does not form, the birth may also be natural, but doctors carefully use the tools so as not to damage the blisters and not infect the baby. In the presence of ulcerations on the birth canal, only cesarean section is allowed.
Mandatory indication for surgery is considered the primary infection. So the likelihood of defeat herpes fetus increases significantly.
In the recurrent form, a woman can give birth naturally, as in 99% of cases the virus will not harm the baby. But the decision should be made in accordance with the recommendations of the doctor. He will carefully review the pregnancy history and determine the risks.
Most often for genital herpes is a planned operation. After the discharge of water, caesarean section is realized no later than 5 hours, otherwise the risk of infection of the newborn increases.
Video from the expert:
Danger to the child
If a baby is infected during delivery, the first symptoms develop after 12 to 17 days. The mildest form is a rash on the skin and mucous membranes. This is the most common type of genital herpes in a child.
The bubbles are single or formed in groups, the size of each 1.5-2 mm, they are filled with serous fluid and are formed in different parts of the body. Blisters burst and heal within 2 weeks.
On the background of rash, ophthalmologic pathologies are progressing:
- corneal erosion,
Less common is optic neuritis, which causes severe visual impairment. If after the diagnosis of rash treatment was not carried out, then in 50 - 70% of cases there is an acceleration of progression.
Sometimes vaginal delivery provoke generalized herpes of the newborn, when the child becomes sluggish, he notes:
- frequent regurgitation
- decrease / rise in body temperature,
- cyanosis of the skin,
- manifestation of shortness of breath
- the spread of the disease process to the liver, spleen and adrenal glands,
- the formation of blood clots in small vessels, in 30% of cases of lesions manifestations of encephalitis and meningoencephalitis are noted.
The nervous system of the child with herpes is affected on the background:
- temperature rise
- strong excitability
- loss of appetite
- tremor of the limbs
- developmental seizures.
If timely post-operative antiviral therapy was carried out for children after childbirth with genital herpes, the risk of death was reduced by 50%. If the treatment is not organized the risk of death reaches 90%.
Treatment: strategy, methods, drugs
Опаснее всего развитие инфекционного поражения в первый триместр беременности. Until the period of 12 weeks, a woman should refuse any oral medications that can somehow affect the development of the fetus.
The standard treatment can be attributed to the drug Acyclovir. It is a powerful medicine that acts directly on the herpetic virus and destroys it. But in the early stages it is prescribed only when it is urgently needed - when the risks of generalization (spreading to internal organs) of infection and death of the embryo increase.
Video about the diagnosis and treatment of genital herpes:
Acyclovir tablets are usually taken within 5-7 days. With recurrent form, it is quite possible to do without this medication.
In such a situation, the doctor often prescribes drugs to strengthen the immune system, multivitamins for pregnant women - Elevit, Complivit Mama, Vitrum Prenatal, Alphabet, etc. In their composition there is a full range of substances needed by the female body during the carrying of the child. During the season it is recommended to consume enough fruits and vegetables.
Since the transition of the pregnancy process to the second trimester and before childbirth, treatment of genital herpes can be carried out with the help of Acyclovir tablets. Take it 4 times a day for about a week. With a repeated exacerbation during the same pregnancy, the dosage is doubled.
Must strengthen immunity. Viferon rectal suppositories are well suited for these purposes, as they help the body recuperate to resist infection. Candles are used for the night course for 10 days.
Rash after childbirth
The appearance of herpes on the lips of women after childbirth causes panic in them, since the overwhelming majority of antiviral drugs are contraindicated for nursing mothers due to their ingestion into breast milk. Only a specialist can prescribe a suitable treatment, self-treatment is prohibited.
Therapy is best to start at the time of formation of the bubbles. Dermatologists generally advise drying drugs - lubrication with a solution of Fucorcin or tincture of propolis.
Additionally, it is good to conduct immunomodulatory therapy in order to strengthen the body's own defenses.
As a supportive treatment, you should walk for a long time in the open air and include more vitamins in your diet.
Care must be taken to prevent infection of the child.
During lactation follow these rules:
- after handling the rash, wash your hands thoroughly with soap,
- wear a cotton-gauze bandage during feeding.
How dangerous is the occurrence of the disease in the last weeks of pregnancy?
Primary herpes before delivery can develop in two scenarios: it has pronounced signs of infection or is asymptomatic.
Infection in the last weeks of pregnancy is extremely dangerous for the baby. Due to the absence of immune protection in the expectant mother, the infection has all chances to get into the child’s body and provoke intrauterine infection, and this is a direct threat to his life. Indeed, in most cases, such a complication leads to the death of the crumbs. If even the child survives, then disability cannot be avoided, because the infection affects all the internal organs and central nervous system of the small organism.
But even in the case when the intrauterine infection does not occur, there is a risk of infecting the child directly in the process of labor activity. Such an outcome is extremely difficult to warn, because the mucous membranes of the genital organs of the future mother are infected, and they will soon become the birth canal.
When the baby is infected directly during labor, there is a risk of neonatal (congenital) herpes. The disease may develop in different ways, but in most cases it is quite difficult. After all, a newborn baby has still unformed immunity, therefore its body cannot withstand a viral attack, and the disease becomes generalized. The virus spreads throughout the body, affecting primarily the umbilical wound, skin, mucous membranes of the newborn, gradually spreading to the internal organs and nervous system.
Of course, congenital herpes is less dangerous than intrauterine infection. However, the probability of death is very real.
Recurrent herpes in the last weeks of pregnancy
The insidiousness of a herpetic infection lies in the fact that, once in the human body, it remains there for life. The virus is at rest, but under favorable conditions (for example, reduced immunity), it tends to activate. However, this form of the disease is less dangerous during pregnancy, and this is due to the fact that during recurrence intrauterine infection occurs extremely rarely, because the future mom's body has already developed protective antibodies to the virus, which protect the fetus from infection. Nevertheless, it is impossible to exclude the fact of infection, because during pregnancy a woman’s immunity is significantly reduced, and, accordingly, the likelihood of developing various infections increases.
Risk of primary genital herpes
Infection with genital herpes during pregnancy represents a huge risk to the fetus. Especially if the infection occurred in the 3rd trimester, and the manifestation of the disease in the form of herpetic eruptions on the genitals appeared shortly before the date of birth. This is due to the fact that a woman has no protective antibodies, and the virus is able to penetrate the blood-brain barrier and adversely affect the baby. In this case, there is a very high probability of infection of the fetus. The virus infects the child’s internal organs, the central nervous system and may even lead to its death.
If primary genital herpes occurred before childbirth, caesarean section is the only method of delivery. Due to the operation, it is possible to avoid contact of the baby with herpes sores during the passage of the birth canal of the mother.
If a woman has a history of the disease even before pregnancy, this indicates that there are protective antibodies (Ig G and Ig M) in her body. Therefore, the child will be protected even in the event of a relapse of the disease. And the probability of this is quite high, because during pregnancy a woman's body weakens, the immunity decreases and many illnesses, including herpes virus infection, worsen. However, this does not carry such a high risk to the fetus as the primary episode of the disease. Although it also requires immediate expert advice and taking the necessary measures.
Is it possible to give birth naturally?
Many women suffering from this disease are interested in the question of who gave birth to genital herpes. In fact, physiological childbirth is quite real, but only in the case when there is no risk to the fetus.
- It is allowed to give birth to a woman whose genital herpes appeared even before pregnancy, and did not manifest itself during the baby’s birth.
- However, the final decision on this issue can only be made by the doctor on the basis of the examination of the patient and the results of laboratory tests for the presence in the blood of protective antibodies of classes Ig G and M.
Therefore, if the pregnancy was calm and there were no recurrences of the disease, the doctor may allow natural childbirth. However, often there are still aggravations, and in this case they approach this issue more carefully.
If the relapse happened no later than 4 weeks before the date of the expected birth, the patient underwent the necessary examination and treatment, and all manifestations of the ailment disappeared without a trace, a decision on physiological labor can be made. After all, there is no risk of intranatal infection of the baby. To further protect the child, the birth canal is treated with Polyvidone, Iodine, Betadine, Vokadin or other antiseptic preparations.
To protect against the occurrence of exacerbations of infection and protect the fetus, it is possible to use antiherpetic immunoglobulin. This preparation contains ready-made antibodies to the Herpes Simplex 2 virus, which suppress the activity of the pathological process.
Immunobiological preparation is administered in the first trimester of pregnancy and again shortly before delivery, but not earlier than after 36 weeks. The use of this drug is recommended for use if a woman wants to give birth on her own, in a natural way. This will protect the baby and prevent the occurrence of a relapse of the disease directly before childbirth.
Antiherpetic immunoglobulin is administered to a pregnant woman only on prescription, with all contraindications. The procedure is done exclusively in the conditions of the medical institution, because the drug can provoke the development of an allergic reaction and other complications. For 30 minutes, the woman should be under medical supervision. Pregnant medicine is used intramuscularly and additionally intravaginally. This will help enhance the therapeutic effect of the immunobiological preparation and achieve a more pronounced positive result.
Is it possible to give birth on your own if the relapse was a week before delivery, at the 39th week of pregnancy? In this case, it is strictly prohibited, and the only way out of the problem situation is a cesarean section. Otherwise, there is a high risk of infecting the baby and the development of serious complications.
How to prevent the development of the disease in a child?
Cesarean section for herpes is performed only when the woman begins natural labor activity. However, this must be done before the rupture of the membranes. This is one of the main requirements for cesarean section for women with genital herpes.
In some cases, an emergency delivery decision may be made if certain indications occur. As a rule, this occurs after 40 weeks of pregnancy, and also if the ultrasound results reveal a violation of vital signs of the fetus.
Immediately after birth, the child takes blood for a specific diagnosis - determining the genetically alien structure of the herpes virus in the plasma by the method of polymerase chain reaction (PCR). Additionally, a serological examination is required to determine the antibodies of class M and G. When they are detected, the analysis must be repeated. An important diagnostic role is played by the growth of antibodies of class M, this indicates the activity of the infectious process.
Depending on the period at which the woman became pregnant with the herpes virus, whether it was the primary episode of the disease or exacerbation of a chronic infection, in some cases there are some signs already at birth.
The disease can manifest itself in the following forms:
- disseminated neonatal,
This condition requires immediate systemic and local antiviral and immunomodulatory treatment.
Even if the newborn does not have any signs of herpes virus infection, he must undergo a course of antiviral treatment. Despite the fact that this is a serious therapy that has a rather strong effect on the infant body, which is not strong enough, it must be passed through. This will avoid the development of complications in the future.
The required dosage, treatment regimen and frequency of use of antiviral agents is determined by a specialist based on the presence or absence of clinical manifestations of the disease and the results of laboratory studies. Monitoring the condition of the baby and regular serological monitoring is carried out for 1 year.
If you have genital herpes during pregnancy, you should definitely consult a specialist. Only a doctor is able to adequately assess all possible risks and decide on the need for treatment and the method of delivery. Herpes virus infection during pregnancy can harm the fetus, so in no case can not be guided by reviews on the Internet. After all, each situation is purely individual, and only a specialist can decide whether the delivery will be carried out by the mothers themselves.
The mechanism of development of genital herpes
Genital herpes is one of the most common and insidious diseases that are transmitted mainly through sexual contact. The main feature of the herpetic virus is that, despite the presence in the body of pathogens, infection of other persons is possible only against the background of their increased activity, that is, during the exacerbation of the disease.
To effectively combat the disease, you need to know its specifics and features. For example, the development of genital herpes occurs in accordance with the following scheme:
- In the vast majority of clinical cases, the foci of viral infection are the mucous tissues of the organs of the excretory and reproductive systems. It is from there that the pathogenic microflora penetrates the lymphatic as well as the circulatory system of the human body.
- The main feature of genital herpes is as follows: in the early stages of infection, viral microorganisms penetrate into the ganglia and remain in them in a latent, that is, latent form, throughout human life, almost without succumbing to traditional methods of treatment. During periods of exacerbation, the carrier of the virus is a potential source of infection.
- The presence in the tissues of the body of the virus leads to a gradual weakening of the natural protective barrier, resulting in a tendency of the patient to develop common infectious diseases. So, for example, frequent colds, swollen lymph nodes and long-lasting fever may well be evidence of infection.
Among the factors provoking an increased activity of viral microorganisms include, among other things, pregnancy and the state-related changes that occur in a woman’s body, that is, a weakening of the immune defense, a general breakdown, hormonal disturbances. But despite the fact that pregnancy with genital herpes is a potential threat to the mother and fetus, timely therapeutic measures will help significantly reduce the risks and prevent infection of the unborn child.
Tip! To prevent complications during pregnancy, a woman is recommended to take the necessary tests already at the planning stage. A timely treatment will reduce the likelihood of infection of the fetus and produce healthy offspring.
Typical clinical picture
In the period of gestation, the manifestations of genital herpes in women are identical to those occurring against the background of the absence of pregnancy.
The symptoms of the disease and the duration of their manifestation depends on the forms of the infectious pathology, including the following:
On the basis of the above, it is possible to draw conclusions that the course of a viral disease is not excluded in the absence of characteristic symptoms. That is why, in order to prevent the detection of herpes and the appearance of the need for drug therapy during gestation, a woman is recommended to take all the necessary tests at the planning stage of pregnancy.
Signs of genital herpes
To prevent possible complications and start timely treatment, which will bring maximum efficiency, a woman needs to know what symptoms herpes causes in the intimate area during pregnancy.
The primary features of this disease are as follows:
- the appearance of severe burning and itching in the perineal region,
- redness of mucous tissues and skin of the external genital organs,
- lesions of the skin of the intimate area, expressed in the appearance of small fluid-filled bubbles, erosion or nodules,
- pronounced painful sensations that can significantly increase when using the toilet,
- the appearance of abundant mucous membranes, and in some cases of purulent secretions with a specific unpleasant odor,
- marked swelling of mucous tissues and skin.
In addition to the listed clinical manifestations, genital herpes may also be accompanied by a slight increase in body temperature, deterioration of general well-being, loss of strength. As a rule, the symptoms of the disease appear for several weeks, after which they gradually fade away even if there is no treatment, that is, the disease flows into a latent chronic form, which is completely more than difficult to identify and cure.
That is why it is so important to timely diagnose viral pathology and take appropriate therapeutic measures.
What is the danger of disease during pregnancy
Despite the fact that in most clinical cases gestation occurring against the background of viral herpes completes safely and is not accompanied by infection of the newborn, in some situations the combination of the concepts “pregnancy and genital herpes” entails a potential threat to the health and life of the infant. Степень опасности напрямую зависит от формы и длительности протекания заболевания.
Статистика различных форм недуга является следующей:
- Особенно часто заражение ребенка происходит на фоне первичного герпеса. About five out of ten babies are born infected or become infected during childbirth precisely when the mother has the disease of this form. The penetration of the pathogenic microflora into the baby’s fragile body occurs through the sores and wounds on the mother’s body at the time of passage through the birth canal or during breastfeeding.
- With recurrent herpes in remission, the risk of infecting the infant is minimized. Against the background of this pathology, no more than three percent of the total number of infants are susceptible to infection.
- The risk of infection increases somewhat if an exacerbation of the genital recurrent virus occurs in a period close to childbirth. According to statistics, in such cases, the infection is detected in three out of ten newborns.
Predominantly infection of the child occurs at the time of passage through the birth canal. To reduce the likelihood of infection, natural childbirth with genital herpes is not welcome, since it is only possible to significantly reduce the risk and prevent infection of the fetus through cesarean section.
Tip! Herpes, which appeared in the first trimester of pregnancy, is especially dangerous for the fetus. Intrauterine infection of the fetus during this period most often leads to its subsequent death, that is, spontaneous abortion or the onset of preterm birth.
Implications for the newborn
The degree of danger to the fetus due to infection of the mother's body with the herpes virus can vary significantly depending on the form of the disease and the time of infection. Especially dangerous for women and children is the penetration of viral microflora in the early stages of gestation. Most often, such a pregnancy ends with premature birth or the birth of a child with severe pathologies and developmental abnormalities.
In the event that infection occurred long before conception, the degree of danger to the fetus is significantly reduced. This is due to the fact that during periods of exacerbation of the existing pathology, the mother's body produces antibodies, the number of which increases over time and contributes to the suppression of the activity of viral microorganisms.
The risk of infecting the infant increases significantly if the delivery starts immediately during the exacerbation of the disease. In such cases, the child’s body is affected by contact with open wounds on the mucous tissues of the birth canal. Accordingly, genital herpes during childbirth carried out by caesarean section carries the least danger. The probability of infection of the fetus in this case is close to the minimum.
The main danger of genital herpes during fetal development is the onset of preterm labor. Also, various defects and pathologies of fetal development, including, for example, lesions of the brain and cardiac muscle, abnormal development of the digestive tract organs and many others, are not exceptions. More details about the negative consequences of this disease will tell the video in this article, as well as a photo archive.
Tip! To reduce the risks of the consequences of genital herpes, you should consult a doctor when even the most minor symptoms of this disease appear. A timely treatment will help prevent most of the negative effects of pathology.
Treatment of genital herpes
Unfortunately, even the use of innovative medical drugs will not completely remove genital herpes virus from the body. However, timely treatment will significantly reduce the possible risks during pregnancy, eliminate the effects of the disease, as well as increase the time interval between exacerbations.
Features of treatment of herpes during gestation depend on the duration of pregnancy and the form of the disease. In the course of therapy, antiviral drugs are used, agents aimed at enhancing and strengthening the immune forces, topical medications that help relieve anxiety symptoms.
The use of traditional medicine, prepared by yourself in accordance with the recommendations provided by the instructions, is also not forbidden.
Standard treatment of genital herpes is determined by the duration of pregnancy, as well as the form of the existing disease. A combination of several therapies is used mainly, including the external treatment of the affected tissues, the administration of drugs that suppress the increased activity of viral microorganisms, as well as immunomodulating agents.
It should be noted that the treatment of herpes before the third trimester of pregnancy is carried out only through the use of funds for external use. The ingestion of potent antiviral medication inside poses a potential threat to fetal formation and growth.
Often, when infected with a virus in the early stages of gestation, physicians suggest artificial abortion, because of the high risk of fetal infection and the development of pathologies.
If there is such an unpleasant combination, such as recurrent genital herpes and pregnancy, the use of drugs is a must. As the main drugs used to eliminate the symptoms of herpes and inhibit the activity of the viral microflora, the following are mainly used, the price of which is almost identical:
With exacerbations of the disease, as well as against the background of the primary disease, significant dosages of drugs are used, the magnitude of which is determined by the attending physician. Under condition of detecting herpes in a latent form, it is recommended to use long-term drug therapy through the use of low dosages of the above agents.
To eliminate the symptoms of the disease, such as, for example, redness, burning, itching and rashes, the use of topical medicines with pronounced anti-inflammatory, analgesic and antiseptic properties is required. To achieve a positive result, you can use the ointment Acyclovir or Viferon.
Women who are wondering about how to give birth with genital herpes and how to reduce the likely risks also need to pay attention to the following aspects: to prevent exacerbation of the disease in the prenatal period and suppress the activity of the viral microflora, the body’s immune forces must be increased. This requires taking vitamin and mineral complexes, using immunomodulatory agents recommended by the attending physician, eating well, spending time with moderate physical activity and more often being in the fresh air.
Traditional methods of treatment
Unfortunately, any, even the most highly effective folk remedy, will not allow to get rid of viral herpes. However, the use of home drugs will help to significantly reduce the unpleasant symptoms of this disease and significantly increase the body's immune strength.
In order to maximally suppress the activity of viruses that cause genital herpes, and to carry out childbirth in a natural way, you can try to use the following tools:
- Applesauce. This tool will help to strengthen the body and remove the main symptoms of the disease. To make it, you should squeeze the juice from two small onion bulbs, grind up one large green apple to puree and mix the available components. In the resulting gruel, you can also add a tablespoon of liquid natural honey, but only in the absence of an allergic reaction to the use of this product. There is ready mashed potatoes should be shortly before dinner and breakfast, one small tablespoon.
- The milk extract of birch buds will save you from itching and burning.which is quite simple to cook. To do this, take a couple of handfuls of dried or fresh birch buds and fill them with one and a half cups of fresh homemade milk. The resulting mixture should be boiled in a water bath, boil for about five minutes and cool under a lid. When the medicine has cooled completely, it is necessary to soak it in abundantly with a piece of sterile gauze and apply it as a lotion to the affected areas.
- It is equally effective to apply freshly squeezed aloe juice or a leaf of a plant cut in half to the affected areas. For best results, it is recommended to fix the sheet with a bandage and leave overnight. Treatment should be until the complete elimination of the rash.
- Excellent regenerative properties have a mixture of essential oils.. For its preparation should be dissolved in one tablespoon of regular almond or olive oil, three drops of lavender and geranium oil. The resulting tool should be at least three times during the day to treat sores and wounds. This composition perfectly dries bubbles and stimulates the healing process.
- Relieve itching and eliminate swelling of tissues compresses, prepared on the basis of the infusion of arnica inflorescences. To prepare such a remedy, brew half a liter of boiling water with two large tablespoons of inflorescences and allow the medicine to infuse under a warm cloth for several hours. In the resulting infusion, it is required to moisten abundantly with clean gauze and, attaching it to the affected area, fix with an elastic bandage. The duration of the course of treatment through the use of such a drug is at least fourteen days.
Those women who wish to conduct natural childbirth, and genital herpes is a hindrance, it must be remembered that the suppression of the activity of viruses is possible only if all recommendations of the attending physician are followed, including with regard to the use of alternative therapy.
Any home remedies listed above can be used only with the permission of a physician. Self-treatment not only does not bring the desired effect, but can also cause a worsening of the patient's condition.
Tip! If in the process of using folk remedies a woman notes even a slight deterioration in general well-being, you should immediately stop the treatment and report it to your doctor.
Why does genital herpes appear in the "position"
Genital herpes in pregnant women is most often caused by herpes simplex virus (HSV) type 2. In 15% of cases, the causative agent of the disease is type 1 HSV. Genital herpes is one of the most common sexually transmitted pathologies. But unlike them, herpes virus infection remains in the body for life. Therefore, there is always a risk of exacerbation of the disease.
During pregnancy, the likelihood of relapse increases due to the natural decline in the body's defenses. Weakening of immunity occurs to prevent the rejection of the fetus, which is a carrier of proteins foreign to the woman, belonging to the father of the child.
Often during pregnancy there is a primary infection. According to statistics, most often people first become infected with HSV type 2 at the age of 20 to 29 years old during sexual intercourse. At the same period, the birth of the firstborn in families. If the husband of the woman is a carrier of herpes virus type 2 infection, she is more likely to become infected from it during the carrying of the child. Before pregnancy, infection could be hampered by her strong immunity. As the body's defenses weaken, the likelihood of infection increases.
During pregnancy, the amount of progesterone, which causes a state of physiological immunosuppression, is constantly increasing. Before delivery, the placenta synthesizes up to 250 mg of progesterone per day.
Therefore, in the third trimester, the likelihood of recurrence and asymptomatic virus release becomes even higher. Increases the risk of primary infection. It represents the greatest danger to the fetus, because before delivery the mother does not have time to form an adequate protective level of antiviral antibodies.
What is the probability of infection of the child during childbirth
If a pregnant woman was first diagnosed with genital herpes before childbirth, the risk of infection of the baby reaches 60%. When the initial infection is asymptomatic, the probability of transmission of the virus to the baby during childbirth is reduced to 40%.
If a woman was infected before pregnancy with the herpes simplex virus and suffered from a relapse of the disease during childbirth, another exacerbation before childbirth with clinical manifestations will cause the child to become infected with a probability of 3%. If the recurrence was not accompanied by symptoms, the risk of infection of the fetus during childbirth is negligible (0.05%).
In the recurrent form of infection, the intensity and duration of virus excretion from the mother is much less than during the initial infection. Protective action is also exerted by specific antibodies passively transmitted from mother to fetus during pregnancy.
If a woman infected before pregnancy experiences a relapse of genital herpes for the first time before giving birth, she risks infecting her baby with a probability of 33%.
The intensity of virus isolation from it will be much higher than with the often exacerbated form. If the first relapse occurred a few days before delivery, the chances of transmitting the virus to the baby during childbirth are reduced to 2–5%. This is due to a small number of lesions, a short period of virus isolation and the presence of antibodies in the mother.
Relapse of herpes infection occurs before delivery in 2–5% of pregnant women. Asymptomatic exacerbation is diagnosed in 20% of expectant mothers in the last weeks of pregnancy.
Despite the high risk of infection during the passage through the birth canal, some children successfully avoid it. However, the threat of getting sick with neonatal herpes persists after birth. In 15% of children diagnosed with neonatal herpes after childbirth, infection occurred as a result of contact with a sick mother or medical staff. The virus is transmitted during contact with the lesions. In some women, herpes sores with genital herpes appear on the skin of the breast. Infection can occur if, after contact with the lesion, touch the baby’s skin without washing your hands.
Factors affecting the likelihood of fetal infection
If a woman before pregnancy was infected with HSV type 1 and during pregnancy for the first time infected with HSV type 2, the probability of infection of her baby during childbirth is reduced by several percent.
The risk of infection increases with massive seeding (the number of viruses in the genital tract and to the fetus) and the use of delivery tools that injure the baby’s skin.
Infection depends on the duration of the anhydrous period of the child and on the immunological reactivity of the woman.
More often, women themselves are infected with weak and premature babies. They are vulnerable to infection, even when the mother has enough antibodies. Transmission of antibodies from mother to fetus occurs at approximately 8 months of gestation. Therefore, premature babies do not have time to get full protection.
What is dangerous infection for the baby
If the infection occurred during childbirth, the first signs of the disease appear in 12-17 days. The easiest form of neonatal herpes is a rash on the skin and mucous membranes of the infant. It is diagnosed in 20-40% of newborns.
Single or multiple vesicles (1.5–2 mm in size), filled with a translucent liquid, appear in different parts of the body in the absence of signs of an inflammatory reaction. They burst and heal within 10–14 days. Against the background of a rash in an infant, ophthalmic diseases can develop:
- herpetic keratoconjunctivitis,
- corneal erosion.
Sometimes there is optic neuritis, causing significant visual impairment. If, upon detection of vesicles, no treatment was started, the disease progresses rapidly in 50–70% of cases.
In some situations, childbirth in genital herpes can cause a generalized form of pathology. The baby looks sluggish and often belches. He has a decrease or increase in body temperature, the skin becomes bluish tinge, shortness of breath appears. There may be signs of pneumonia. The pathological process often extends to the liver, adrenal glands and spleen. DIC syndrome may develop (blood clots in small vessels). 30% of babies show signs of encephalitis and meningoencephalitis.
Herpetic lesions of the nervous system occur in the background:
- increasing body temperature
- increase excitability
- trembling limbs
- reduced appetite
- the appearance of seizures.
If the children of those women who have given birth to genital herpes were treated with antiviral treatment in a timely manner, the probability of their death will be less than 50%. In the absence of therapy, the risk of infant death increases up to 90%.
Как распознать генитальный герпес у беременной
Первичный генитальный герпес в большинстве случаев проявляется в виде сыпи на больших и малых половых губах, а также в области промежности. On examination, the gynecologist detects lesions on the vaginal mucosa and on the cervix. For herpes, a woman may complain of:
- difficulty urinating (dysuria),
- urethral and vaginal discharge,
- pain in the groin.
In places of defeat, she feels burning and itching. There is swelling and redness of the skin (or mucous membranes).
Pregnant women have weakness, decreased performance. They suffer from headaches and insomnia. The body temperature may slightly rise (up to 37–37.5 ° C).
Very often (up to 60% of cases) an atypical form of genital herpes is diagnosed, when only vaginal discharge indicates activation of the virus. Can I ignore these symptoms, the doctor will find out after conducting research.
In some cases, a generalized form of herpes infection develops. It is characterized by damage to the organs and systems of the body of a pregnant woman. The generalized form of genital herpes most often develops at the end of pregnancy and lasts until the birth. In most cases, it is associated with primary infection.
What to do when aggravated genital herpes before childbirth
If a pregnant woman has a primary infection after 34 weeks, she is scheduled for a planned cesarean section. To give birth alone is not safe.
In some cases, it is possible to achieve a significant improvement in the health status of a woman at the time of delivery through the use of Acyclovir. Therefore, sometimes the doctor may decide to cancel the caesarean section.
The undoubted indication for caesarean section is the presence of lesions on the genitals and the release of HSV from the cervix at 40 weeks. Caesarean section is carried out if resistance to Acyclovir is detected, as well as in cases when premature rupture of amniotic fluid has occurred.
If the episode of exacerbation or primary infection occurred before 34 weeks, the woman is allowed to give birth in the most natural way. In order to minimize the risk of infecting a child during childbirth, Acyclovir is prescribed from the 36th week of pregnancy.
In addition, immunostimulants and immunoglobulins can be recommended. During childbirth, women are treated with genital tract antiviral drugs (solution of semi-dan). To reduce the likelihood of infection, limit the number of vaginal examinations during delivery and prohibit the use of obstetric tools. After the baby is born, it is carefully examined and, in the absence of signs of infection, prophylactic treatment with Acyclovir is performed.
If a woman has developed a severe form of genital herpes, she is prescribed Acyclovir at any stage of pregnancy.
Opinions of women who gave birth with genital herpes
Reviews of women who have given birth to children after the diagnosis of genital herpes indicate a low probability of infection in the recurrent form of the disease and the feasibility of caesarean section in the case of primary infection before birth.
“From time to time herpes jumped out during pregnancy, but gave birth to two healthy children. The doctor did not say anything. Gave birth naturally. ”
“A week before cesarean, genital herpes came out. Never had before. Caesar and so it was appointed, and this fact was one hundred percent reason for the operation, so that the child through the genital tract is not infected. Everything went well. For the first months, I rubbed the hands for 15 minutes with a special solution before taking the child. Herpes itself disappeared 2 weeks after birth. ”
Prevention of complications
The responsible period is not only pregnancy, but also the first days and life of the baby. Regardless of the nature of the delivery, during this period a young mother should be especially careful, since the immune forces of the baby’s body are still too weak and most susceptible to the entry of pathogenic viruses.
As the basic rules, to observe which it is categorically necessary in the first and subsequent days after birth, they call:
- If the skin of the mother has rashes and requires their treatment by using antiseptic solutions, after the procedure, you should not only wash your hands thoroughly, but also wipe the skin with any disinfectant.
- If the baby has been infected during labor, care should be taken to ensure that the infant does not touch the affected tissue, as this is fraught with the rapid spread of the virus.
- When located in the immediate vicinity of the child, it is recommended to use cotton-gauze dressings, the use of which will help minimize the risks of infection of the baby.
- Natural feeding is permissible to carry out only if there are no rashes and lesions on the skin of the breast, which is characterized by genital herpes. In the presence of such, it is recommended to temporarily transfer the baby to artificial feeding.
- Strictly not allowed the child to be in the parents' bed during sleep. Moreover, it is recommended to change daily not only the underwear, but also the child’s bedding.
- As additional preventive measures, it is also necessary to mention standard procedures, which will help strengthen the baby’s body and reduce the risk of infection. Among them: regular walks and airing the room, healthy nutrition of the mother, providing the child with all the microelements and substances necessary for growth and development, daily bathing and compliance with additional medical prescriptions, if any.
The rules listed above apply not only to the mother, but also to the father of the newborn baby. Detection of a disease in a woman indicates, as a rule, a partner’s infection.
Accordingly, the risk of infection of the baby in contact with the father is present, although it is minimal. It should also be noted that the successful completion of pregnancy is not a direct indication for stopping the treatment of genital herpes. It is necessary to carry out therapy in the postpartum period, if there are indications for this.
The mother of the newborn also should not forget about the measures to prevent viral disease in the postpartum period. Daily treatment of the skin, taking the necessary antiviral drugs and medicines that promote the raising of immunity, are mandatory. In addition, it is recommended to follow the basic rules of healthy eating, take vitamins, maintain personal hygiene.
Fortunately, thanks to the achievements of modern medicine, genital herpes is not a sentence during pregnancy. Timely taking the necessary medications, following medical recommendations, and, if necessary, caesarean section, will significantly minimize the risk of contracting the baby and increase the chances of having a completely healthy and full-fledged baby.
Mothers who ask questions about whether it is possible to breastfeed with genital herpes, there is no need to worry. With the observance of all rules and the absence of medical contraindications, breastfeeding during this period is not only possible, but also very important for strengthening and developing the infant's immunity, as well as its full growth and development.