In detail

Pregnancy and the herpes simplex virus

Pregnancy and the herpes simplex virus

Question:

- I am pregnant in 12 weeks and a herpes has appeared in my mouth. What risk would I have and what should I do?

Answer:

The herpes simplex virus belongs to a large group of DNA viruses, which have the ability to survive throughout the life of the host, which can cause recurrent infections. Also, they have a special obstetric importance, due to its harmful effects on the product of conception.

There are 2 main antigenic types of herpes simplex: type 1 and type 2. If initially it was considered that the lesions in the genital sphere would be produced only by type 2 and the perioral ones (around the mouth) by type 1, at present it is known that at least ¼ of the genital lesions are produced by type 1, which usually produces lesions in the upper half of the body.

What is not yet known is whether the neonatal risk differs depending on the type of virus involved, recent research suggesting that they are of no importance.

Infections during pregnancy and the diseases caused

Herpes simplex infection during pregnancy involves maternal risks (neurites, meningitis, meningoencephalitis, oncogenic potential through possible correlation with cervical cancer), as well as fetal risks: increased incidence of miscarriages and premature births, rare but severe birth defects , affecting the central nervous system and, in particular, the generalized herpes of the newborn, with a very serious evolution.

Transplacental infection of the fetus is extremely rare, but possible. Contamination is usually by direct contact, at the time of vaginal birth, if the mother has genital herpes lesions. The exact risk of perinatal infection has not yet been established.

Women with genital herpes simplex infections, during the first half of pregnancy, have a significantly increased incidence of spontaneous abortions, (without being able to say precisely whether these abortions were caused by the generalized intoxication of the mother or the transplacental transmission of the virus to the fetus ).

Maternal infection after 20 weeks of pregnancy is associated with an increased incidence of premature births and direct transmission of herpes virus to newborns, these risks being higher, in cases of primary infection (if this is the first time the woman has an infection with herpes). In very few cases, children can become infected with herpes simplex after birth by contact with the mother who has herpes mouth lesions.

Prevention and intervention

Taking all of the above into account, it is recommended that you carefully monitor your pregnancy with your gynecologist and investigate a possible genital herpes infection (if you have only oral herpes infection the risks are reduced and only in the event of transplacental transmission, which is considered rare).

Any suspected lesion will be collected and a cytological examination will be performed and any pregnant woman should also perform a routine Pap test, which is also useful in detecting asymptomatic infections.

In the second trimester of pregnancy, women at risk for developing herpes infection should be followed at regular intervals. These frequent controls allow for a smooth birth when herpes infection occurs at the beginning of the third trimester but is resolved before labor is installed or allows the cesarean section to be performed in the case of active lesions, thus preventing the infection of the newborn.

Tags Genital Herpes Pregnancy Pregnancy