How to treat genital herpes during pregnancy and how dangerous is it?
When a woman is worried that she may have genital herpes during pregnancy, she usually takes care of the fetus. Therefore, if you want to familiarize yourself with the consequences of a herpes infection in the genital area during pregnancy that can harm an unborn baby, this is written at the very end of this article. But the article also reveals questions about the causes, symptoms and treatment of genital herpes in women during pregnancy.
The main key of genital herpes during pregnancy is the virus carrier during the acute stage or during exacerbation of the disease. In this connection, a woman becomes infected from a partner during sexual intercourse. Record high infection is observed among people aged 20 to 35 years. Usually, people with a fairly large number of sexual partners or a person who has started sexually at an excessively early age are at the highest risk.
The pathogen and its development in the body
Genital herpes in a pregnant woman, in most cases, is caused by the causative agent of the herpes virus 2 type. This is a clinical version of herpes simplex. The duration of the incubation phase is from two days to almost two weeks. The virus penetrates the skin of the external surface of the genital organs, as well as through the mucous membrane of the urogenital system. Then it is embedded in the circulatory system, as well as in the lymph nodes.
At the initial stage, genital herpes during pregnancy goes deep into the nerve endings. Further, the virus penetrates through the cytoplasm of particularly sensitive processes of nerve cells to:
- segmental nerve glands - where the innervation of the skin reflects genetic connections,
- peripheral ganglia - part of the nervous system outside the brain, spinal cord,
- regional nerve nodes - a specific area of the human body with an independent nervous area.
In these nerve cells, the virus is stored in a sleep mode, that is, in a latent form. The lumbo-sacral division of the nerve nodes of the spinal cord is intended for the storage of the virus and serves as a key during sexual transmission in the acute stage.
Recurrent genital herpes has long been one of the common viral infections transmitted through sexual intercourse of partners. Its pathogen is significantly different from other viruses in that it lives in the human body forever, being in a latent form (sleep mode) until a certain time and is not easily given to specific therapy.
Recurrent genital herpes occurs as a result of damage to the nerve and epithelial cells, and cells that belong to the immune system. This is clearly expressed by the huge number of changes in the clinical direction and secondary deficiency of immunity. In this regard, there are frequent recurrences of the disease, occurring with subfebrile body temperature, an increase in lymph nodes, sometimes with mental disorders.
Causes of virus activation and transmission
Genital herpes, both in early pregnancy and subsequently, can easily be provoked:
- sexual contact with a virus carrier
- directly by the pregnancy itself,
- significant hormonal modifications
- serious mental injuries,
- nervous fatigue,
- frequent sleep deprivation or poor sleep,
- overheating and overcooling,
- diseases of the internal organs of a chronic nature.
A significant level of infection, exacerbation, density and varying intensity of clinical manifestations substantially depends on the number and energy of microorganisms. The total duration of their exposure depends on the barrier state of the placenta and mucous membranes. As well as the level of infection is observed at a time when the protective functions of a pregnant woman or fetus are subject to the least resistance to viruses.
Genital herpes and pregnancy is an extremely incomparable phenomenon, but nevertheless it is quite possible to get a sexually transmitted infection in early pregnancy. This problem is very dangerous for the future mother as well as for the fetus. Morphological elements are expressed immediately after the incubation stage on the third, sometimes on the fifth day of the actual lesion. At the time of the ultimate stressful situation, the first symptoms and signs of genital herpes, both external to the genital lips, and the general ones begin immediately.
On genital lips during pregnancy, genital herpes is expressed by such somatic signs as:
- the rapid development of severe general weakness
- state of apathy,
- fever, chills,
- severe headaches, nausea and vomiting,
- frequent urination,
- an increase in the inguinal lymph nodes with severe pain,
- vaginal herpes leads to additional vaginal discharge,
- the appearance of watery bubbles on the surface of the labia,
- itching and burning in the genital area,
- severe pain and bodily discomfort in the genitals and on the surface of the labia.
Skin rash in genital herpes in pregnant women is manifested in the form of small transparent watery bubbles that are prone to association. Around the bubbles, the skin turns red and sore.
From the minute of the possible appearance of bubbles until the moment of their bursting, as a rule, it takes from two to four days. At the beginning of the occurrence of weeping ulcers, which form a crust during healing. With timely treatment, after about a week, the crusts will begin to fall off, and the mucous membranes and skin will begin to heal. If the treatment of genital herpes in pregnant women is not carried out, the disease can last for almost a month.
Exacerbations of chronic genital herpes during pregnancy are not as painful as in the case of primary infection. The clinical picture of the chronic course of the disease is very diverse. The stronger the immune system of the human body, the faster and easier the disease passes. Up to the complete absence of certain signs. Even if a rash appears in the genital area, as a rule, the maximum duration of the disease does not exceed one week. In some cases, only puffiness appears in the mucous and skin areas, sometimes with redness.
During the formation of shingles in pregnant women, pain occurs along the nerve, the rash is widespread throughout the perineum.
It is not recommended to treat genital herpes being in a position without medical examination by a specialist in a gynecological clinic. Many drugs are contraindicated for use by expectant mothers. Impeccable treatment variation is a linear combination of methods such as:
- drug therapy to suppress the active virus,
- symptomatic therapy to accelerate the healing of lesions,
- correction of the immune system to increase immunity.
Specialists such as a dermatologist, gynecologist and venereologist, after a medical examination and with the correct differential diagnosis, know exactly what and how to treat genital herpes in a woman during pregnancy. First of all, external treatment of the affected genital area with antiseptics and antiviral ointments is prescribed.
- Acyclovir - tablets, ointment. As a rule, in this situation, women are prescribed Acyclovir. The drug is quite effective in terms of targeted exposure. For a short time, it relieves the symptoms of herpes simplex virus type 2 (HSV-2), significantly reducing the time of its activity.
- Panavir - gel. For external use. Highly effective means that does not allow the virus to grow and multiply. It leads to their rapid destruction of herpes.
- Vitamins of group B.
- Medicines prepared on the basis of such herbs as Echinacea, Ginseng, Eleutherococcus.
- Tea with honey. A decoction of black currant leaves and raspberries.
- Tea with lemon.
Some medications for the treatment of genital herpes during pregnancy are prescribed only in cases where the intended benefit to the woman exceeds the possible risk to the fetus.
Consequences for the fetus
Possible negative outcomes of fetal development vary. It depends on the duration of infection of a pregnant woman.
- 1 trimester Miscarriage, threat of miscarriage, missed abortion, congenital deformity, complete or partial damage to organs at the developmental stage,
- 2 and 3 trimesters. Early untimely delivery, heart disease, pneumonia, serious breakdowns of the liver, disruption of the spleen.
Treatment of newborns who have become infected intrauterinely, in rare cases, gives a positive result. The kid either dies or is born an invalid. Due to fetal infection, the results can be as follows:
- Cerebral palsy,
- epilepsy and other consequences.
Neonatal virus is expressed by a diverse level of manifestation. As a rule, the baby is born with symptoms of herpes on the skin, rarely - on the genitals. The virus that infects the nervous system is fatal in 50% of cases.
With the development of the herpes simplex virus at any time, before childbirth, herpes is transmitted to the child. Only 6% of babies are born with symptoms of a focal lesion during the relapse of the disease.
Summing up, it is worth recalling that during pregnancy it is most dangerous for the first time to become infected with genital herpes. Since the initial infection will be more dangerous for the fetus, because the pregnant woman does not have antibodies to herpes in the blood, which means that herpes can penetrate to the fetus and disrupt the proper development. If during pregnancy there was a recurrence of herpes, it is urgent to begin treatment, while it is better to consult a venereologist, and not a gynecologist, since it is much easier to diagnose genital herpes just to the venereologist.
How does the infection occur?
Herpes infection is caused by a virus that can only live in the human body - Herpes viridae. This microbiological family is very numerous, but only three types of it are dangerous for people: HSV-1, HSV-2 and HSV-3. A patient can be affected by only one type, and can have two or even three types at the same time.
The virus can not live long outside the cells of the body, as it can exist only in high humidity conditions. In addition, it can destroy temperature drops that differ from normal body temperature.
According to the international classification of diseases of the virus of genital herpes, the following codes are assigned:
- A.60.1 - perianal infection,
- A.60 - anogenital infection,
- B00.9 - unspecified infection.
To get from a sick person to a healthy virus can in several ways:
- Sexual way. The greatest probability of getting sick after sex with someone who has the disease is in the acute stage (there is a rash or sores on the intimate organs).
- Contact-household way. Such infection occurs after using bath towels, bathrobes, crockery, underwear or bed linen of the patient.
- Transmission from mother to child during pregnancy (vertical transmission). In this case, the virus penetrates the placenta or is introduced through the skin and mucous membranes of the baby during childbirth.
- Autoinfection. Occurs when a rash spreads through the body after contact of hands and herpes sores.
Women are more at risk of infection, and at the time of pregnancy, especially since this period is characterized by an increased stress of the immune system, which makes the mother’s body more vulnerable.
Signs and manifestations
If the infection after infection has invaded the blood, the virus begins to move in the direction of blood flow. Reaching the nodes of the nervous system, the virus settles there and is in a latent state until the beginning of the active phase.
From the hidden state of the disease can bring such factors:
- serious illnesses
- strong stresses and feelings,
- any operations (especially with general anesthesia),
- insomnia and lack of sleep
- hypothermia (especially the legs and pelvis) and overheating,
- hormonal fluctuations.
Manifestations of the disease depend on the form the disease takes:
- Primary. If the infection occurred during pregnancy or shortly before it and the appearance of symptoms of herpes infection occurs for the first time, then we are talking about the primary disease. Its symptoms are usually very pronounced.
- Recurrent. This form occurs with repeated exacerbations after the first episode of the disease. During pregnancy, relapses often occur even in those women who successfully stopped the disease earlier, since immunity is weakened at this time.
Symptoms of primary genital herpes
After the incubation period, which lasts about 4 days in pregnant women, the temperature begins to rise (sometimes its values reach 38 ° C), dizziness and headache appear. The condition of a pregnant woman often resembles the onset of a cold.
In the second stage of the disease, herpes causes a rash, which occurs in this way:
- first, in the area of the external genital organs there is a strong itching, burning, noticeable redness,
- skin in the areas of development of lesions swells or swells,
- nodules filled with clear fluid appear,
- After 3-4 days, the vesicles open and leave behind small sores, which gradually heal.
The strongest burning, itching and pain accompany the appearance of herpetic vesicles, and as the healing proceeds, the discomfort subsides and disappears. After the ulcers have healed, no scars, scars or other cosmetic defects remain in their place.
Rashes can be few, and sometimes they form large groups that affect large areas of the skin.
Genital herpes during pregnancy appears in such places:
- vaginal epithelium,
- cervical canal and urethra,
- pubic area.
If the body of a pregnant woman is acutely responding to the development of a herpes infection, the appearance of a rash is often accompanied by an increase in lymph nodes in the pelvic area, an abdominal pain, and vaginal discharge can be observed with copious secretions containing mucus or pus. Sometimes the acute phase causes aching muscles, frequent bouts of nausea, or even sleep disturbances due to severe discomfort in the perineum and on the vulva.
Another frequent symptom is discomfort during urination and bowel movements. Since, during pregnancy, the perineal area, as a rule, swells due to increased blood supply, and genital infection further enhances this effect, toilet visits can cause many unpleasant sensations.
After the herpetic eruptions heal, the symptoms subside and the disease goes into a latent phase.
Symptoms of recurrent genital herpes
The overwhelming number of complaints about the manifestations of infection in pregnant women is not associated with the initial appearance, but with the recurrence of the disease. During all trimesters in the woman’s body, dramatic hormonal changes occur, and this is a powerful factor for the next exacerbation.
The secondary course is characterized by less acute symptoms, the temperature does not occur, the lymph nodes do not swell. Bubbles with liquid appear on the same places where they were located for the first time.
In pregnant women, recurrences can be repeated several times, sometimes new rashes occur before the old ones heal, and the disease takes on an ongoing character.
What is dangerous genital herpes during pregnancy
The degree of risk for a developing fetus depends on when the woman was infected. If the infection and the first exacerbation occurred before pregnancy, then the embryo is protected by maternal antibodies, which are transmitted to it through the general bloodstream. In this case, the virus will not have any effect on the formation of the child's body.
A completely different situation may occur if genital herpes first manifested itself during pregnancy, and antibodies are not yet developed.
The degree of negative impact depends on which trimester the infection occurred:
- First trimester - the most dangerous period. The virus can provoke severe malformations, in the form of defects in the structures of the brain and spinal cord, hearing impairment up to deafness, blindness and other deviations in physical development. Often, primary genital herpes in the first trimeter becomes the cause of fetal death or miscarriage.
- Infection in second trimester often provokes disturbances in the work of the blood-forming organs, skin defects, herpetic encephalitis, lung damage, the development of neurotic abnormalities, etc. The threat of miscarriage in this trimester is reduced, but the probability of stillbirth or death is high during the first month of life.
- If infection occurs in third trimester, it is often decided on an urgent cesarean section to prevent the harmful effects of herpes infection on the formation of the child.
All pregnant women in the third trimester are carefully examined for herpetic vesicles in the birth canal. Если их обнаруживают, то в момент родов половые пути обрабатывают специальными противовирусными средствами, которые не позволят инфекции перебраться на кожу малыша.In addition, damage to the skin of the child during childbirth is trying to minimize.
For caesarean section, women with genital herpes have a number of indications:
- appearance of fresh rash on the eve of childbirth,
- infection in the ninth month in the absence of antibodies in the mother’s blood,
- detection of genital herpes virus in the cervix according to analyzes without visible signs,
- severe relapse and resistance to antiviral drugs,
- premature discharge of amniotic waters, despite the fact that the pregnant woman had previously had an infection.
If a cesarean is carried out according to plan, then 2 weeks before the operation a small dose of antiviral drugs is prescribed to the woman, because even a cesarean section does not guarantee the full safety of the child during delivery.
After birth, prophylactic intravenous drugs are injected into the baby to suppress genital herpes.
As for the nutrition of the newborn, it must necessarily be breastfed, since the antibodies contained in human milk will be able to prevent infection or speed up recovery.
For the determination of genital herpes during pregnancy, a qualified gynecologist sufficiently visual inspection. If the clinical picture leaves doubts, the doctor sends the patient to a detailed examination using such methods:
- isolation of the virus or its DNA and RNA,
- serological tests based on the detection of antibodies in the blood.
Materials for analysis are:
- scrapings from rashes,
- smears from the mucous tissues of the urethra, vagina or cervical canal,
The main tests that confirm the presence of genital herpes infection:
- PCR (allows to identify and distinguish the recurrent or primary form),
- culture sowing.
Full therapy in pregnant women is prescribed only in cases of severe forms of genital herpes.
Tactics of treatment differ depending on the trimester in which the course is prescribed.
Course in 1 trimester:
- intravenous antiviral drugs (injections or droppers),
- a course of human immunoglobulin (single dose - 25 ml), 3 doses at intervals of one day,
- processing rashes aniline dyes.
Course in the 2nd trimester:
- droppers with acyclovir or panavir,
- immunotherapy - 3 doses of 25 ml of human immunoglobulin every other day, candles with viferon, 2 candles per day for 10 days,
- application of acyclovir cream every 2-3 hours.
Course in the 3rd trimester:
- four times the introduction of acyclovir or panavir for 2-3 weeks,
- immunotherapy - 3 doses of 25 ml of human immunoglobulin every other day, candles with viferon, 2 candles per day for 10 days,
- application of acyclovir cream every 2-3 hours until the healing of the bubbles.
All dosages are adjusted by the attending physician.
Local drugs used in the treatment of genital herpes infections do not affect the child, since they are not absorbed into the mother’s blood.
To control the effectiveness of the treatment, after a month, re-scraping of the cervical epithelium is performed for analysis by the method of polymerase chain reaction.
It is important to know that the risks associated with genital herpes during pregnancy can be minimized. To do this, follow these recommendations:
- always use condoms during sexual intercourse,
- give up oral sex before giving birth,
- Be sure to undergo a scheduled ultrasound scan in due time.
The best prevention is the conscious planning of conception and pregnancy, during which you should get rid of chronic diseases and inflammations, strengthen the immune system, cure foci of infection (caries, sinusitis, gastritis).
Subject to the implementation of all preventive measures, as well as timely treatment and accurate adherence to all the advice of doctors, the chance to give birth to a healthy baby is greatly increased.
Additional information on the diagnosis and treatment of genital herpes, including during pregnancy, is presented in this video.
What is dangerous genital herpes during pregnancy?
All herpes viruses are combined into a family, and the classification of pathogens is based on the similarity in the structure of the virion and its pathogenic action. Herpes simplex virus (HSV) belongs to the alpha subfamily and is divided into 2 types: the first and second. Both types are capable of damage to the mucous membranes of the oral cavity, genitals, skin of the upper and lower half of the body. However, herpes type 2 is most often found in the intimate area, and the first type is found on the face.
Infection with HSV occurs in early childhood, therefore, among adults, in 97-99% of cases, immunoglobulins are found against the virus. The frequency of herpetic manifestations is determined by the individual characteristics of the immune response.
Almost all pregnant women have a protective titer of immunoglobulins to the herpes virus, since they already met with the pathogen by the time of conception.
After the first meeting with the herpes virus and the development of a typical clinic, there comes a stage of latency - asymptomatic carriage. The duration of this phase is different. From the time of initial infection, relapses are increasingly recorded with a gradual decrease in exacerbations.
Herpes, affecting the skin and mucous faces, the head is much more common than genital. During pregnancy, both genital variant and labial herpes are dangerous, involving the mucous membranes of the nose and mouth. But the frequency of exacerbations is crucial. With a single recurrence of herpes does not threaten the fetus.
Genital herpes during pregnancy is also dangerous for frequent relapses, and during childbirth, the probability of infection of the child during the passage through the birth canal is high. A child born to an HSV-positive mother has a protective titer of antibodies in the blood for a year, so herpes in children at that age is rarely registered.
Is herpes dangerous during pregnancy?
Genital herpes is considered a problem in those situations if the immune system is not able to block the reproduction of HSV, which is manifested by frequent relapses and the involvement of large areas of the mucous membranes and skin of the genitals in the process. In view of this, several provoking factors and features of infection are distinguished, which lead to frequent exacerbations, severe course and involvement of the fetus and placenta in the process:
- the effect of herpes on the immune activity, the ability of the virus in the physiological weakening of the immune system in a pregnant woman to "manage" immune cells, by inserting blood lymphocytes into the chromosomes. In such situations, the antibodies produced are defective and unable to suppress the process of genital infection,
- the presence of a pregnant severe infectious pathologies of the chronic course of any localization,
- severe early toxicosis and preeclampsia,
- endocrine diseases, overweight and diabetes,
- the presence of genital infections (human papillomavirus infection, chlamydia, chronic thrush, bacterial vaginosis).
When answering the question of how herpes affects pregnancy, it should be noted that the ability of immunity to resist the pathogen is the primary factor that determines the presence or absence of influence on the fetus. If antibodies block the virus, the possibility of penetration through the placental barrier is leveled.
The virus penetrates to the fetus through the placenta or cervical canal in the presence of genital herpes in the vagina and on the surface of the cervix.
Herpes simplex virus during pregnancy can have a negative effect on the developing fetus. The effect of herpes can manifest itself in the following pathologies and conditions:
- Frozen pregnancy (developmental) in the early period.
- Hypoxia due to the development of placental insufficiency.
- Fetal lag in development.
- Impaired production of amniotic waters (low water or high water).
- Childbirth ahead of time.
- Fetal infection of the fetus.
- Congenital herpetic infection during infection during vaginal and early postnatal periods.
- Infringement adaptation of the baby.
The type of pathology depends on the period of infection of the fetus.
Especially exciting for women is the question of how dangerous genital herpes is when infected already at the time of conception. The greatest risk is genital herpes in the case of primary infection during the coming and developing pregnancy. In such situations, the penetration of the virus through the placental barrier occurs in 60-70%.
Many women regard herpes sores of various locations as a sign of pregnancy. Herpes - as a sign of pregnancy has a chance for truth. Given the fact that the onset of pregnancy leads to a physiological decline in immune activity, genital herpes may be a sign of its occurrence.
The process of implantation of the embryo is accompanied by the beginning of the functioning of the corpus luteum of the ovary, which produces progesterone. This hormone has an immunosuppressive effect. Inactive herpes virus, which is in the nerve trunks and branches begins to multiply and ensures the development of the clinic of genital herpes, as well as labial.
But this symptom develops after the delay of the next menstruation, therefore, it should not be considered early. Pregnancy tests or chorionic gonadotropin blood tests will be more reliable.
Clinic of genital herpes in pregnant women
From the moment of conception, a woman may have a relapse of genital herpes. The severity of symptoms is individual, as is the frequency of exacerbations.
Symptoms of a herpetic genital infection are:
- The onset of the disease is characterized by pain along the nerves innervating the genitals. The pain extends to the buttock, thigh, gives in the groin, crotch. It is one-sided.
- Feeling of chills, fever may join.
- After the stage of pain comes the rash phase. On the skin of the external genital organs or the area of the anus, a hyperemic spot appears, swelling, which quickly becomes covered with small vesicles with transparent contents. The number of bubbles may be different. On the mucous membranes, in the vagina and on the cervix, bubbles appear without a phase of hyperemia.
- Rash in the vagina is accompanied by his swelling and severe pain during intercourse.
- Bubbles of genital herpes quickly open, forming painful erosion, often bleeding.
- All stages of clinical manifestations are accompanied by itching.
- There is an increase in vaginal discharge. They become more watery, sometimes turbid.
- On the skin, the rashes become crusted and dry, and on the mucous membranes they remain as weeping erosion.
- The healing of foci of genital herpes lasts from 1 to 4 weeks, depending on the severity and number of rashes.
These symptoms describe the classic picture of genital herpes. But quite often, atypical forms are recorded in the form of an isolated pain syndrome that flows without a rash stage, as well as severe types of infection in the form of a common lesion or hemorrhagic form with hemorrhages. In the presence of concomitant bacterial complications, genital herpes is able to undergo suppuration.
Herpes vesicles contain a large number of viruses, so rashes on the cervix, in the vagina, on the labia during pregnancy are dangerous primarily by infecting the child during childbirth.
Despite the presence in the infant of protective antibodies from the mother, no one can give guarantees of complete safety, since not in all cases the quantity and quality of antibodies have the necessary characteristics. Therefore, obstetricians are wary of genital herpes in pregnant women and carry out a complex of preventive and therapeutic measures.
The genital appearance of herpes in a pregnant woman may recur with varying frequency. With rare exacerbations (1-2 times) there is no risk for the child, but frequent relapses — more than 4 times during pregnancy — require medical intervention. In addition, the danger of genital herpes is largely determined by the massiveness and localization of lesions. It is believed that a large number of lesions on the mucous membranes increases the risk of the virus in the blood and fetal-placental blood flow.
A genital infection with a minimal amount of vesicles or a relapse only in the form of pain syndrome is not dangerous for a child. This means that antibodies block the virus.
Primary infection with genital herpes during pregnancy occurs with the same symptoms as a relapse, but with more pronounced signs of intoxication. Infection occurs through sexual contact with a patient with genital herpes partner.
In early pregnancy, as well as in the second and third trimester, infection of the fetus is likely if the pathogen enters the bloodstream, and then through the vessels of the placenta and umbilical cord to the baby, through the cervical canal. As a rule, viremia with genital type - the presence of the virus in the blood - is characterized by fever, severe chills, headache, fatigue.
In almost 80-85% of pregnant women, the genital herpes type is uncomplicated and is not dangerous.
The initial gestational age - 1 trimester - is the period when all the organs and systems of the fetus are laid. Therefore, at this time viral damage of dividing cells, developing organs is fatal. The most common infection of the embryo ends in two variants of development:
- spontaneous abortion,
- embryo development.
In the early period of gestation, genital herpes is exacerbated quite often. But the most dangerous disease is with extensive involvement in the process of the mucous membranes, vagina, cervix, rectum.
Consequences in the 2nd trimester
In the second trimester, herpes sores can often disturb a woman due to the increasing burden on the immune system. The middle of pregnancy or the 2nd trimester is described by fully formed systems, but with emerging organs, therefore, virion penetration to fetal tissues can have a negative effect on organs, leading to abnormal development.
The following outcomes are possible in the second trimester:
- stillbirth during infection of the fetus at the beginning of the 2nd trimester or when there is a pronounced weakening of the mother’s body
- damage to nerve tissue and brain - microcephaly, hydrocephalus,
- damage to the organ of hearing in the form of deafness,
- atresia of the rectum, esophagus, vagina in girls.
If developmental abnormalities are detected, the pregnant woman has the right to both leave the child and agree to an artificial birth from week 23, or an abortion until week 22.
Frequent exacerbations of the genital infection during pregnancy lead to intrauterine infection in 2-25% of cases.
Complications of infection before childbirth
In the third trimester, genital herpes can cause operative delivery if an exacerbation occurred at week 39 or more, when childbirth can occur at any time. In such situations, drug treatment may not lead to proper effect due to its duration.
The end of pregnancy or the 3rd trimester means the complete formation of all the systems and organs of the child, so the most common outcome of infection with the genital herpes type leads to the following:
- if vaginal herpes worsens from 30 to 36 weeks, the likelihood of congenital infection, manifested by encephalitis, meningoencephalitis, hepatitis, bowel disease, hemorrhagic syndrome, increases,
- in case of recurrence of genital herpes from week 37, the greatest risk of infection of the child occurs during natural childbirth.
During exacerbation of genital herpes in the last months of pregnancy, as a rule, natural childbirth does not allow, and carry out an operative delivery - cesarean section.
Of those women who gave birth with genital herpes due to the abandonment of operative labor or in case of emergency labor outside the hospital, the responses are different. Infection of the child and the manifestation of herpes infection is largely determined by the state of immunity of the mother, which transmits antibodies, and the state of the newborn. Most often, infection occurs and the manifestation of acquired infection. Herpes in babies develops a few days after birth. The main features include:
- cyanosis of the skin,
- convulsive syndrome
- pneumonia (respiratory failure, shortness of breath),
- defeat herpes rash mucous membranes and skin.
The responses of pregnant women about the consequences of genital herpes for a child after operative delivery are positive and are characterized by a lack of information about the infection of the child. It should be borne in mind that the presence of herpes sores on the genitals should be accompanied by careful personal hygiene of the mother. Virus contact with the mucous membranes and skin of a newborn baby can also cause illness. Women with viral infection give birth in the observational department.
Type 2 hhv treatment
Genital herpes during pregnancy are treated in two ways:
- системное лечение осуществляется интерферонами и препаратами ацикловира,
- местное лечение.
Вопрос, чем лечить герпес при беременности, интересует всех женщин. Safe to use during gestation are interferon preparations, starting from 12-13 weeks of pregnancy. Genital herpes in the first weeks of pregnancy is not subjected to systemic medical treatment, as drugs can harm the developing embryo.
Treatment of herpes in second-trimester pregnancy is accompanied by the use of immunomodulators - interferon preparations (Cycloferon, Genferon, Viferon, etc.) in the form of rectal suppositories. Courses are assigned individually and can be repeated. In particular, before childbirth with recurrent genital herpes, a preventive course of immunomodulators is required.
Since it is unsafe for the fetus to treat the genital form of the infection with Acyclovir, administration of the drug is carried out in exceptional cases. But, given the high level of danger of the influence of the virus on the child, experts use antiviral drugs. Acyclovir is used in 2 and 3 trimesters in the form of tablets most often.
Local treatment of herpes in the intimate area is accompanied by the appointment of ointments, desiccants and healing agents. Before smearing the rash, the treatment is performed with antiseptic solutions and herbs decoction: a solution of potassium permanganate, hydrogen peroxide, a decoction of oak bark, chamomile, calendula, sage. Then apply antiviral ointment, which is allowed to apply on small areas of the skin from the second trimester. Use tools such as Zovirax, Virolex and others.
To speed up the healing of the genital eruptions, the lesions are smeared with Solcoseryl, Levomekol and Bepanten. To dry herpes on the skin of the genitals, dyes (Fukortsin, brilliant green, methylene blue), zinc paste, baby powder are used.
Among the dietary supplements during pregnancy for the treatment and prevention of genital herpes use tools such as Traumel-C, Engystol.
In addition to the main treatment of genital herpes, take complex vitamins to strengthen the immune system, avoid overheating and hypothermia. Sexual contact with a genital infection is prohibited.